Posted on 12/13/2002 2:11:28 PM PST by FreeSpeechZone
Dangers, Experts Warn Against Vaccinating Children
s smallpox vaccination for the public comes closer, many experts say the risky vaccine should not be offered to children and teenagers, even on a voluntary basis.
While federal health officials have not yet said whether children would be vaccinated under the plan President Bush is to announce today, they and doctors who advise the government on smallpox policy suggested yesterday that in the absence of a smallpox attack, good sense dictated that only adults get preventive vaccinations.
Vaccinating even part of a population can drastically slow an epidemic, experts said, and children are relatively easy to protect by closing schools and keeping them home. Nor would they be needed, as many adults would be, to serve on the front lines in a smallpox outbreak — running hospitals, giving emergency vaccinations, caring for the sick, delivering medical supplies and food, keeping water and sewer and phone systems running.
At the same time, the smallpox vaccine is the most dangerous in existence, especially to children. It is a cousin of the vaccine developed 200 years ago, when Dr. Edward Jenner pricked the sores of a milkmaid infected with cowpox and jabbed the lancet into the arm of a boy, giving him the virus, which protects humans against smallpox.
Experts say vaccinating children poses major ethical problems and legal liabilities that were unknown decades ago, when schoolchildren were routinely vaccinated. Children under age 18 cannot give informed consent, said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, "and that's an important ethical difference."
Existing stocks of vaccine have been in storage since the 1970's, and the new vaccine expected to be ready by 2004 has not been tested on children. Any child vaccinated would, in effect, be part of a large human experiment. If there were side effects, the government might be held liable.
Although severe reactions to smallpox vaccines are relatively rare — estimates of future reactions range from 1 in every 8,000 vaccinations to 1 in every 67,000 — they are much more common in younger children.
In the past, said Dr. Martin Blaser, chief of medicine at New York University Medical School, children with undetected immune problems were the most likely to suffer or die.
"If you reached 18, you were probably not immuno-deficient," Dr. Blaser said. "Getting a live vaccine was the acid test of immuno-deficiency."
Routine smallpox inoculations stopped in 1972. Today, many more people are vulnerable to complications, including anyone who is H.I.V. positive, is receiving chemotherapy, has had an organ transplant, or has a history of eczema, which has become more common in the last 30 years.
A 1968 study found that the 14 million smallpox vaccinations given that year caused nine deaths, seven of them in children under 10 years old, according to Dr. William Bicknell of the Boston University School of Public Health.
Encephalitis from vaccination, a dangerous inflammation of the brain, occurs almost exclusively in younger children.
If children and teenagers are excluded, the chances of "contact vaccination," in which the vaccine virus is passed from one person to another who touches the sore, are sharply reduced.
Of 114 cases of contact vaccinations in 1968, Dr. Bicknell said, "almost all were in children." The only other two he could remember were of a hospital nurse and between a couple who had had sex.
Contacts between adults in workplaces are rare, Dr. Fauci said. By excluding teen-agers, he said, "you're not vaccinating people who are spending all day horsing around with each other in school."
Experts said that although parents might now be eager to have their children vaccinated, their enthusiasm might wane with the inevitable reports of serious side effects among some military and emergency personnel.
"People are frightened about smallpox because it's in the news a lot," said Dr. Paul Offit of the Children's Hospital of Philadelphia. "It's possible that by 2004, that will settle down."
Dr. Offit opposes vaccination not only of children, but also of emergency personnel on the ground that there is not one case of smallpox in the world. "If you were trying to make a smallpox vaccine today and this was it, it wouldn't be licensed," he argued.
In contrast, he said: "Flu will kill 20,000 people this year, mostly less than 4 years old — and we have a vaccine. It's too bad that Saddam Hussein's not behind influenza. We'd be doing a better job."
Dumb and Dumber!
Wed Dec 11, 7:41 PM ET By LAURA MECKLER, Associated Press Writer
WASHINGTON (AP) - Federal health officials are considering a national television ad campaign as part of an effort to help people decide whether to be vaccinated against smallpox, a disease not seen in this country for more than a half century.
Officials said Wednesday that an education campaign aimed at the general public will begin soon after President Bush (news - web sites) announces plans for offering the vaccine.
Polls, including one released Wednesday, show most people would get the vaccine if given the chance. But health officials fear that many people do not adequately understand the risks.
"The success of a vaccination program is going to depend on our success in communicating with people accurately and openly," said Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention (news - web sites). That includes explaining the risks of the disease — and of the vaccine.
The education effort has several elements, including outreach directly to health care providers. Already, some of it has begun quietly.
Last week, 37,000 clinicians and public health officials participated in an eight-hour CDC smallpox tutorial that covered how to vaccinate people and how to run a vaccination program. Nearly 150,000 clinicians have seen a CDC smallpox video explaining how to diagnose someone with the disease. Some 250,000 pamphlets explaining the details of vaccination have been distributed over the last several weeks.
The CDC Web site has been loaded with data and photos about vaccination and about the dangerous side effects that can accompany it.
Next week, the CDC will host representatives from each state to train them on how to deliver the vaccine. These people will then train others in their states.
Once the vaccination program is announced, officials will begin targeting information to the general public. Among the options are TV ads, Gerberding said.
"We'll be moving very aggressively," said Joe Henderson, the CDC's bioterrorism chief.
Smallpox was declared eradicated from earth in 1980, but experts fear it could return in an act of bioterror.
But the vaccine itself is also risky. Studies from the 1960s suggest that for every million people being vaccinated for the first time, 15 will face life-threatening side effects and one or two will die.
Bush is considering how quickly to offer the vaccine. Top health officials have recommended a phased program where the vaccine would be offered first to hospital emergency room workers and special response teams, then to first responders and all other health care providers and finally to the general public.
Once these vaccinations begin, and once the first death or serious side effects are reported, enthusiasm for the vaccine is likely to plummet, said Jerry Hauer, the top bioterrorism official at the Department of Health and Human Services (news - web sites).
Officials also fear that any negative publicity about the smallpox vaccine could dampen enthusiasm for regular childhood vaccines, which are very safe. But that can be minimized with good education up front, Hauer said
While I agree that we are better prepared to deal with small pox now, I find it difficult to dismiss the carnage caused by small pox throughout human history on populations that had no exposure (and, thus, no immunity).
That's right. Most of us died 50 years ago when we were vaccinated as children. Or thought we were going to die. Big, ugly scab.
We understand the vaccination has worn off, that nobody is immune now. Is that true?
What exactly do you mean by that?
Phew! That makes me feel better.
One certainly don't want a bunch of minors making their own decisions while at at physical risk in a medical program fraught with ethical and legal problems.
Now, let's discuss something less clear cut, like teen age abortion....
I love that. Can I use it?
Remember aruanan, it wasn't the innoculation that got rid of smallpox. It was sanitation.
That explains why all those third world countries have no smallpox, yet people die by the bucketload from malaria, the FIRST disease to be reduced with improved sanitation.
Got it?
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.