Smallpox: Tennessee prepares

By Abby Morris
Star Staff
amorris@starhq.com

   As President George W. Bush considers making small pox vaccinations available to the general public, state health care officials are preparing for the vaccination of key individuals after the start of the year, as well as making plans for a mass vaccination of the public in the event of a smallpox outbreak.
   Bush is expected to make an announcement today about his decision to make the vaccine available to all people, beginning with military personnel and health care workers.
   According to the Associated Press, the vaccine will be made available to the general public on a voluntary basis as soon as large stockpiles are licensed, probably in 2004, but the government will not encourage people to receive the vaccine.
   In a press briefing on Tuesday transcribed at www.whitehouse.gov, White House press secretary Ari Fleischer told reporters the threat of small pox is one the United States is taking seriously.
   "This is a very important matter for the President. It's a matter that he's approached with care and deliberation," Fleischer said. "He has, I think, properly and wisely taken time to make his determinations about whether or not to proceed with any type of smallpox inoculation program or vaccine program for the American people."
   U.S. Senator Bill Frist (R-TN) said that he supports Bush in his decision.
   "I welcome the President's decision to make the smallpox vaccine available to all Americans," he said. "It's the right step to protect the American people and it's the right step to make our nation less vulnerable to those who would use smallpox to terrorize our citizens. This is a difficult decision, but it's the right decision."
   Frist, the ranking member on the Senate's Subcommittee on Public Health, has been addressing the issue of bioterrorism since 1998 and has been one of the biggest proponents for vaccinating the public against smallpox.
   "As I have been advocating for many months, a policy of allowing people to make an informed choice about whether to get the smallpox vaccine should be the cornerstone of our vaccination policy," Frist said. "I look forward to working with the administration to ensure the American people have the information they need to make the right choice for themselves and their families."
   According to the Centers for Disease Control, it is estimated that 1,000 out of every one million people who receive the vaccine will experience serious but not life-threatening reactions to the virus. Less than 60 out of one million will suffer serious life-threatening reactions. It is also estimated that one or two people out of one million who are vaccinated will die as a result of the vaccine.
   Careful screening of potential recipients is the key to avoiding such side effects, according to the CDC. Individuals who have weakened immune systems due to HIV/AIDS, cancer treatment or organ transplants are discouraged from receiving the vaccine as are women who are or who may become pregnant or people with skin conditions such as eczema or atopic dermatitis.
   As the debate goes on over making the vaccine available to everyone, states are still preparing vaccination plans.
   In early November, the Tennessee Department of Health began planning for what is being termed "post-event vaccination." It would consist of a mass vaccination of the residents of Tennessee in the event a case of smallpox is confirmed.
   The mass vaccination plan would call for 117 clinics across the state to administer the vaccine to all of Tennessee's residents within 10 days. The clinics would operate in two shifts a day and be able to vaccinate 5,000 people a day. The clinics would be run by trained health care professionals and community volunteers. It is estimated that 25,000 people would be needed to operate these clinics.
   According to Dr. Wendy Long, assistant commissioner of the TDH, the counties which would house the clinics have been identified already. "The task now is to identify and prepare the specific sites," she said.
   In what is being termed "pre-event vaccination," the TDH is asking areas to vaccinate persons who would be needed to deal with an outbreak of smallpox, if one were to occur. "A team would be assembled in each acute care hospital as well as Public Health Investigation teams across the state," Long said.
   The job of the investigations teams would be to go into an area and confirm or deny that a case of smallpox is present. There will be a total of eight such teams across the state. "Those are located strategically throughout the state so they could respond quickly," Long said.
   An estimated 13,000 people in Tennessee would be vaccinated according to the pre-event plan. The vaccinations are expected to begin in late January.
   Shirley Hughes, regional emergency response coordinator for the Northeast Tennessee Regional Public Health Office, said that this area of Tennessee is on track with the state's plans. "We've identified a site in our area (to vaccinate health care workers) and area hospitals have identified staff to receive the vaccine," she said.