Federal Health Officials Announce Support for Pre-Attack Smallpox Vaccinations
In a "profound shift in thinking" from previous recommendations, CDC, HHS and NIH officials on Friday said they support making the smallpox vaccine available to everyone in the United States once it is licensed by the FDA, the Washington Post reports. The voluntary vaccination plan calls for "ever-expanding access to vaccine" and would proceed in three stages. First, about 500,000 people at "greatest risk" for contracting the disease -- including public health investigators, emergency room workers and hospital janitors and security guards -- would receive the vaccine. Then about 7.5 million medical workers and three million firefighters, police officers and rescue personnel would be inoculated. Finally, the vaccine would be available to the general public, possibly by early 2004 (Washington Post, 10/5). "We live in a society that values individual choice," CDC Director Dr. Julie Gerberding said at an HHS briefing, adding that the government should "let people make up their own mind" about receiving the vaccine (Kemper, Los Angeles Times, 10/5). Gerberding "cautioned" that the inoculation plan is not an outright recommendation that people should receive the vaccine, but rather that they should "weig[h] the risks and benefits for themselves," the New York Times reports (Altman/Gay Stolberg, New York Times, 10/5). In addition, officials noted that their proposal does not necessarily reflect the views of President Bush, who has not stated his preferences on the issue. "We represent the public health perspective, but the decision also has to be made on the grounds of homeland security and national security," Gerberding said (Los Angeles Times, 10/5). White House spokesperson Scott McClellan said a vaccination policy is "under review." Developing the policy is "extremely difficult" given the risks of mass smallpox vaccination, Jerome Hauer, HHS assistant secretary for emergency health preparedness, said (Washington Post, 10/5). According to government estimates, for every one million people who receive the smallpox vaccine, about 15 would develop "life-threatening conditions" and one or two would die (Los Angeles Times, 10/5).
Friday's proposal "goes far beyond" an earlier proposal from the CDC's Advisory Committee on Immunization Practices, which suggested that only medical investigators and first responders should be inoculated before a smallpox attack occurred, USA Today reports. That report suggested all other people receive the vaccine through a "ring-vaccination" policy, in which people who first contract smallpox following an attack would be isolated and vaccinated, followed by an outwardly expanding series of vaccinations for people who came into contact with those infected (Manning/Sternberg, USA Today, 10/7). The AP/Nando Times reports that although the White House has not officially announced its position on the issue, "top Bush administration officials, including Vice President Dick Cheney" support a mass vaccination of a majority of people in the United States before a potential attack occurs (Meckler, AP/Nando Times, 10/5). However, the American Academy of Pediatrics today released a policy statement disagreeing with the mass-vaccination approach, calling for ring vaccination instead. Smallpox vaccines "are not nearly as safe as other vaccinations we routinely use, and they're for diseases that are around, unlike smallpox," Robert Baltimore of Yale Medical School and a co-author of the statement, said (Elias, USA Today, 10/7). NPR's "Weekend Edition Saturday" reported on HHS' smallpox vaccination recommendation (Knox, "Weekend Edition," NPR, 10/5). The full segment is available online in RealPlayer Audio. ABCNews' "World News Tonight" Friday also reported on the recommendation (Stark, "World News Tonight," ABC, 10/4). A video clip of the segment is available online in RealPlayer.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.