Smallpox Vaccine Rollout Begins

Interest Low Among Connecticut Health Care Workers

(CBS)  Health care workers who volunteered to receive the first round of smallpox inoculations are preparing to roll up their sleeves to be vaccinated in the hopes they can be ready to respond if there is a bioterrorist attack.

Ultimately, the government plans to vaccinate nearly 500,000 health workers across the country so they can become part of response teams for treating patients in an attack.

The first shots were to be given to officials from Connecticut's Department of Public Health and medical personnel from UConn Health Care Center on Friday, the day a law protecting those giving the shots from lawsuits takes effect.

Approximately 20 states have requested the vaccine for members of smallpox response teams. Nebraska, Vermont and Los Angeles County have received vaccine shipments already but were waiting at least until next week to proceed with the vaccinations.

The Connecticut team is expected to travel to different state hospitals in mid-February, administering the vaccine to other doctors, nurses and nurse-practitioners who volunteer for the program.

Staff at some hospitals in upstate New York received the shots earlier this week.

Although the shots are recommended, not required, some health care workers and hospitals are refusing because of the risks from the vaccine itself.

The California Nurses Association on Thursday urged hospitals in that state not to participate in the program, saying there was no proof a smallpox attack is likely.

In a recent survey, 63 percent of 2,600 nurses responding said they would get the smallpox shot, 13 percent said they wouldn't and 24 percent were undecided, according to the National Network for Immunization Information, a coalition of several health trade groups.

In Connecticut, where health officials set a goal of vaccinating approximately 6,000 workers — an average of 150 people per hospital — the early response is much lower.

Christopher Cannon, of the Office of Emergency Preparedness for the Yale-New Haven Health System, has overseen vaccine education programs at 17 hospitals in southern Connecticut. He said those hospitals are averaging between 20 and 30 volunteers.

"It's not overwhelming," Cannon said. "I think there are a lot of people sitting on the fence at this point, waiting to see how the first phase goes."

The decision is complicated by several issues, including possible side effects and the perception that the threat of a smallpox attack is relatively low.

The last natural case of smallpox occurred in Somalia in 1977. The last case in the United States was more than 50 years ago. Routine vaccinations here stopped in 1972, but the vaccination program was reintroduced in December 2002 by the government amid fear the disease could return in an act of bioterror.

In addition to the voluntary vaccines for health care workers, President Bush also ordered the mandatory vaccination of 500,000 members of the military. The president himself received the shot.

Smallpox is one of the deadliest diseases on the planet, killing about a third of the people it infects and scarring many of the rest for life. Passed by contact, its onset is usually fast and devastating, and there is no cure.

Still, the risk of such an attack is unknown, and the chances that any given person will encounter the virus are particularly small.

Meanwhile, the risks of the vaccine are well documented: Based on historical information, as many as 40 people out of every million being vaccinated for the first time will face life-threatening reactions, and one or two will die.

Side effects are a grave concern with the smallpox vaccine because, unlike some other vaccinations, it contains live virus. Some recipients develop a condition in which the small amount of virus contained in the vaccine multiplies beyond control.

For that reason, people with immune disorders, like AIDS, or chronic skin disease, like eczema, cannot get the vaccine. Pregnant women and children are also not supposed to receive it.

However, the tiny amount of live virus can be transmitted by people who've been vaccinated. For that reason, patients must keep the area of injection covered to avoid allowing passing any virus on to people who cannot take the vaccine.