Two Hospitals Refuse To Provide Smallpox Vaccine to Workers
Officials at Grady Memorial Hospital in Atlanta and Virginia Commonwealth University in Richmond, Va., yesterday said they would not adhere to President Bush's request to vaccinate front-line medical workers against smallpox, saying the risks associated with the vaccine outweigh the "remote threat" of a biological attack with the virus, the Washington Post reports. Children's Hospital of Philadelphia, Emory Medical Center in Atlanta and the University of Iowa Hospitals and Clinics also are considering not vaccinating their staffs. The hospitals' refusal to vaccinate marks the first "high-profile" opposition from the medical community to Bush's smallpox vaccination plan, the Post reports (Connolly, Washington Post, 12/18). As part of the plan, the government in late January will begin to vaccinate about 439,000 civilian emergency workers not at high risk for side effects as part of a 30-day voluntary program. In the second phase of the vaccination plan, which will take between 45 and 90 days, federal and state governments will move to vaccinate about 10 million health care workers; government officials estimate that about half of the workers will decide to receive the vaccine (California Healthline, 12/16).
The Post reports that many physicians do not think the Bush administration has made a compelling argument for vaccinating workers against a disease that has not been seen since 1980 (Washington Post, 12/18). Dr. Carlos del Rio, chief of medicine at Grady Memorial, said the risk of vaccinating medical workers cannot be justified yet in a hospital full of sick patients. "I don't want recently vaccinated people running around our clinics and our wards. Even though the risk is small, there will be a risk of the vaccine virus being disseminated to somebody," he said. Hospitals also are concerned about the unresolved issues of liability for vaccine injury and whether workers' compensation would pay for vaccination-related injuries. However, Grady officials said they will reevaluate their decision should the risk of a smallpox attack increase (McKenna, Atlanta Journal-Constitution, 12/17). CDC Director Julie Gerberding said, "We understand not all hospitals will choose to participate." However, she said she expects the "vast majority" of facilities will vaccinate their staff (Washington Post, 12/18).
In related news, Brisbane, Calif.-based VaxGen has announced plans to develop a vaccine that may be safer than the current vaccine in the U.S. stockpile, the San Jose Mercury News reports. The company has signed an agreement with Japan's Chemo-Sero-Therapeutic Institute for the rights to a vaccine that was tested in Japanese children in the 1970s (Jacobs, San Jose Mercury News, 12/17). The agreement will allow VaxGen to produce the vaccine, which caused "no serious side effects" during testing (Dow Jones/Wall Street Journal, 12/18). When compared to conventional smallpox vaccine, the Japanese vaccine produced fewer instances of fever and redness at the site of injection. However, the vaccine did not produce the "characteristic scab," which indicates effectiveness, in more than 90% of the children. While some experts say there is insufficient evidence to indicate the Japanese vaccine is safe and effective, VaxGen officials said they plan to conduct clinical trials next year and hope to win FDA approval by 2004. Once approved, VaxGen plans to market the vaccine commercially to consumers who want protection against smallpox but fear the existing vaccine. It is not clear if the government would purchase any of the vaccine. Like the conventional inoculation, the vaccine uses a live virus and therefore would not be recommended to those with compromised immune systems (Pollack, New York Times, 12/18). The FDA has said it will expedite the review process for the vaccine, the AP/Mercury News reports (AP/San Jose Mercury News, 12/17).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.