HHS To Vaccinate 500,000 Health Care, Emergency Workers Against Smallpox

According to HHS officials, the agency will soon vaccinate about 500,000 health care and emergency workers against smallpox in an effort to prepare for a potential bioterrorist attack, the New York Times reports. The proposed number of vaccinations is much greater than the 15,000 recommended by a committee of public health experts that advises the federal government on vaccination policy, and the Times reports that the increase "in effect acknowledges that the government's existing program is insufficient to fight a large outbreak" (Broad, New York Times, 7/7). Last month, the Advisory Committee on Immunization Practices said that the government should offer the smallpox vaccine on a voluntary basis to an estimated 10,000 to 20,000 individuals who would be the first to respond to a deadly bioterrorist attack and address any suspected smallpox cases. The decision affirmed support for the "ring vaccination" policy that the CDC recommended last November. Under the policy, local health officials during a bioterrorist attack would locate smallpox victims, isolate those exposed to the disease and vaccinate victims and those in contact with victims (California Healthline, 6/21). But HHS Secretary Tommy Thompson will "likely ... go far beyond the panel's position," according to "several of his top advisers," the Washington Post reports. The first vaccinations could begin within eight weeks, Jerome Hauer, HHS acting assistant secretary for emergency preparedness, said. As more vaccine is produced, immunizations could be made "widely available" to the public on a voluntary basis (Connolly, Washington Post, 7/8). Hauer added that over the next several weeks, HHS expects to send "planning documents" on how to best conduct mass vaccination programs to cities and states in an effort to speed vaccine delivery after a potential attack.

HHS officials said that the plan for expanded vaccinations, which has not yet been approved by Thompson, is possible because "crash" manufacturing and stockpiling efforts have greatly increased the supply of vaccine. About 100 million doses of the vaccine -- or 160 million if diluted -- are currently available, and more than 280 million doses -- enough to vaccinate every American -- are expected by the end of the year. The government's ring vaccination policy was criticized as inadequate against the potential efforts of a "moderately skilled enemy intent on mayhem," the Times reports. HHS officials said that criticism had "no direct role" in changing the policy (New York Times, 7/7). HHS' potential policy shift was bolstered by a study published today in the Proceedings of the National Academy of Sciences that found that only 560 people would die from side effects after a mass vaccination of all Americans, compared to 4,680 people who would die if 1,000 people in a city of 10 million became infected with smallpox and a ring-vaccination policy was used (Vergano/Sternberg, USA Today, 7/8).

Americans "should be able to decide for themselves" whether or not they want to receive the smallpox vaccine, according to a Wall Street Journal editorial today. While there are risks to mass smallpox immunization, those that choose to receive the vaccine would "go in with that knowledge" and people with immune deficiencies, who are more vulnerable to complications, could be "screened at a careful pace in advance [rather] than in a panic amid an attack." The editorial concludes that the Bush administration "needs to assert some leadership over a public health bureaucracy that doesn't appear to trust average Americans. Why should the government deny preventive medicine to citizens to voluntarily seek it?" (Wall Street Journal, 7/8).