State Officials, Health Providers Question Timetable for President Bush’s Smallpox Vaccination Plan
Some state officials and medical experts yesterday expressed doubt that public health officials could implement President Bush's national smallpox vaccination plan within the proposed time frame given the "major logistical hurdles" of vaccination, the New York Times reports (Altman/Broad, New York Times, 12/13). Bush today is expected to announce a plan under which 500,000 military personnel and 500,000 first responders would receive the vaccination "within weeks" and the general population could begin to receive the vaccine on a voluntary basis in 2004 (California Healthline, 12/12). State and local officials said that some hospitals are just beginning preparations to provide the vaccinations and many facilities need additional time to resolve issues such as educating health providers and the public; reducing the risk of side effects from the vaccine; ensuring that hospital care will not be jeopardized if workers get sick; and determining who will be responsible for liability claims. New Mexico State Epidemiologist Dr. C. Mack Sewell called the federal smallpox plan "too ambitious," saying that doctors "need time to build up experience" dealing with the potentially harmful vaccine, the Times reports. Dr. William Schaffner, chair of the department of preventive medicine at Vanderbilt University and adviser to the Tennessee Department of Health, said hospitals were "scrambling" to implement the plans. "It's a huge task to do in a relatively short time, 30 days," Schaffner said, adding that even if the time frame was extended to six weeks it would be a "huge load."
However, federal officials yesterday said that the effort to prepare states for the immunizations had "paid off" and that problems implementing the plan would be "small," the Times reports. The CDC yesterday said that an initial review of state vaccination plans was "encouraging"; Monday was the federal deadline for states to submit their plans to vaccinate health care workers. HHS Secretary Tommy Thompson said, "We are extremely pleased and quite impressed with the plans that have been submitted to the CDC so far. It is obvious that state and local health departments and hospitals have stepped up to the plate under an extremely tight timetable" (New York Times, 12/13).
In related news, federal health officials and many physicians said that children should not receive the smallpox vaccine, "even on a voluntary basis," the New York Times reports. Medical experts noted that children are more susceptible to "severe reactions" from the vaccine, including encephalitis, and vaccinating them poses "major ethical problems and legal liabilities," according to the Times. In addition, experts said that because new doses of the vaccine have not been tested in children, vaccinating them would be like a "large human experiment," the Times reports. Further, experts expressed concern that the federal government would be held liable if vaccinated children were to experience side effects. The chances of "contact vaccination," in which the vaccine virus is passed from one person to another when in contact with the sore, are "sharply reduced" when children are excluded from the vaccination plan. Adult vaccination is safer because "you're not vaccinating people who are spending all day horsing around with each other in school," according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (McNeil, New York Times, 12/13).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.