- WASHINGTON (Reuters) - When
health-care workers start inoculating 500,000 Americans against the smallpox
virus next year, they will see side-effects not seen in 30 years -- sore,
swollen arms, scary-looking scabs and perhaps even illness serious enough
to hospitalize a few people.
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- President Bush said on Wednesday he was going ahead with
widely expected plan under which 500,000 military troops would be vaccinated
right away, and another 500,000 health-care workers a few weeks later.
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- These health-care workers would then be protected against
smallpox in case of a biological attack, and could be available to vaccinate
others.
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- Smallpox was eradicated in 1978, but experts believe
Iraq has at least tried to develop smallpox into a biological weapon that
it may use if attacked by the United States.
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- Bush was forced to balance the risks of the vaccine against
the theoretical risk of a biological attack.
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- "We stopped using this vaccine when this disease
was eradicated because it was dangerous," Dr. Julie Gerberding, head
of the U.S. Centers for Disease Control and Prevention, told reporters
in a recent briefing.
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- The United States stopped vaccinating the public in 1972,
but there is a small group of people who have been vaccinated recently
under studies aimed at seeing if 30-year-old stocks of the vaccine could
be diluted and stretched out.
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- Doctors conducting those trials said they have seen startling
side-effects -- reactions not seen with today's improved vaccine technology.
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- "We did have a lot of people calling us in a panic,"
said Dr. John Treanor, who has tested the vaccine on volunteers at the
University of Rochester in New York. "They are only scary because
people are unfamiliar with using the vaccine."
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- About one in five people get a big red lump at the vaccination
site. The vaccine is a solution containing a live virus, called vaccinia,
which is related to smallpox. This is scratched into the skin using a two-pronged
needle.
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- OOZING BLISTERS
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- If the vaccine is successful, the patient develops an
oozing blister that shows the vaccinia has infected the body. If all goes
well the body responds with a targeted attack that leaves it primed to
also attack and eliminate smallpox virus.
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- "Those relatively large reactions can be associated
with swelling of the lymph nodes in the armpit, which can be painful,"
Treanor said. "You can get malaise. Ten percent or so may have missed
a couple of days from work because they didn't feel up to coming in."
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- "This is just what the vaccine is doing in the process
of making you immune to smallpox, but it is not very comfortable."
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- People can also develop a more serious rash over parts
or all of their bodies. "We don't understand why people get that rash,"
Treanor said. "It does look kind of alarming."
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- Like a cold sore, the blister "sheds" a virus
that can be passed from person to person, or spread to other parts of the
body. "If you get vaccinia in your eye, you can become blind,"
Gerberding said.
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- Out of every million people who got the vaccine in the
1960s, two died of serious complications such as encephalitis and another
14 were sick enough to go the hospital.
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- Experts are not sure what to expect today. "Although
the vaccine may be the same, we are different," Washington state Secretary
of Health Mary Selecky told a recent conference.
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- "How many people do you know who have gone through
chemotherapy today, and how many did you know, or did your parents know,
in 1954?"
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- Former cancer patients, people infected with the AIDS
virus, transplant recipients and others with suppressed immune systems
are all more susceptible to severe side-effects from a live virus vaccine.
So are people with eczema, which for some reason is more common than it
was 30 years ago.
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