- WASHINGTON (Reuters Health)
- Public health officials must have the authority to quarantine and forcibly
vaccinate the entire population--with the help of the military if needed--in
the event of a smallpox attack on the US, a bioterrorism expert said Monday.
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- Massachusetts and other states have laws allowing authorities
to force mass vaccination to stem outbreaks of smallpox or some other highly
contagious disease. But the federal government has no enforceable way of
guaranteeing widespread vaccination, even as it prepares to spend billions
of dollars to increase vaccine stockpiles and beef up the public health
infrastructure.
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- ``You can't have a patchy response. There has to be compulsion''
to vaccinate in the event of the attack, said Dr. Stephen D. Prior, the
research director at the National Security Health Policy Center.
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- ``Each state has different laws and that's one of the
problems,'' he said.
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- The government is in the process of procuring 300 million
smallpox vaccine doses, enough for every person living in the US. Officials
from the Centers for Disease Control and Prevention (CDC) say that they
have no plans to institute mass vaccination because there is currently
no identifiable threat of a smallpox attack.
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- Smallpox vaccination used to be routine, but regular
inoculations were stopped in 1972. About 40% of the US population has never
been vaccinated and lacks immunity to the disease, which is fatal in about
one third of cases.
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- Authorities currently plan to deal with any possible
smallpox outbreak by vaccinating in a widening circle around a newly discovered
case. Such a practice is useful with a relatively fixed population, but
would essentially be useless as unsuspecting citizens carry the virus onto
planes traveling across the country, Prior said.
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- Dr. Anita Barry, the communicable disease control director
for the Boston Public Health Commission in Massachusetts, told a Senate
subcommittee last Friday that states needed the authority to confine infected
persons to their homes for quarantine.
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- Federal law gives the US Surgeon General the authority
to vaccinate and quarantine individuals to protect the public health. ``But
he has no means of enforcing it,'' Prior said.
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- A spokesman for Senate Health, Education, Labor, and
Pensions Committee Chair Edward Kennedy (D-MA) said that federal law on
mass vaccination is not part of the bioterrorism bill lawmakers are expected
to consider soon.
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- ``We've heard the issue but we've done nothing with it,''
said spokesman James Manley.
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- Military planners are currently mulling whether or not
they should have a role in enforcing mandatory mass vaccinations or quarantines
in the event of a highly contagious biological attack, said Edgar H. Brenner,
the co-director of the Inter-University Center for Legal Studies in Washington.
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- Brenner told reporters that he had discussed the potential
plans with high-ranking military officials. ``They had no answer yet,''
he said. But Pentagon spokesman James Turner could not confirm the conversations
Brenner mentioned or that officials are discussing such plans.
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- Prior acknowledged that the potential for federally enforced
mandatory vaccinations could arouse anti-government sentiments in some
sectors of the American public. Any mass-vaccination policy would also
have to take into account the vaccine's side effects. Historically, the
smallpox vaccine caused serious reactions in about 1 in every 4,000 persons
and death in about 4 per 1 million.
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- ``The debate has to take place, and the public has to
be involved,'' he said.
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