- In a major shift in public health policy that underscores
government concerns about bioterrorism, federal health officials are gathering
enough smallpox vaccine to inoculate the entire country and are considering
a widespread vaccination campaign.
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- By December, according to public health leaders in Washington
D.C., the U.S. government will have more than 100 million doses of the
vaccine in hand, an amount they say could be effectively diluted to make
the shots available to everyone in the country. An inoculation effort using
the sometimes risky vaccine would be new to millions of Americans born
after the United States stopped offering the shots in 1972.
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- Public health leaders stressed Thursday that discussions
of any vaccine campaign are preliminary, and that the decision to get the
shots would be voluntary.
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- But the announcement represents a significant shift.
Restarting vaccinations in advance of any outbreak, raised as a possibility
in prominent medical journal articles and at a news conference, runs counter
to current federal plans calling for using the vaccine stockpile only after
an outbreak.
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- "There's an assumption the risks associated with
the vaccine may not be worth it," said Dr. Anthony Fauci, director
of the National Institute of Allergy and Infectious Diseases. "But
there might be a lot of people who feel they're willing to take that risk.
It's important to hear that."
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- Risky Vaccine
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- Those risks are well-documented. Smallpox is deadly,
and was largely eradicated worldwide only by a massive public health effort.
But the current vaccine is also dangerous, expected to cause hundreds of
deaths and sicken thousands more if it is offered on a large scale.
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- But top government health officials said Thursday that
reinstating the smallpox immunization program after 30 years is something
the country must consider -- and the decision should not be made in a vacuum.
Nor is the United States alone. The Russian Health Ministry said Tuesday
it was also considering resuming vaccinations against smallpox.
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- For months, the government has been debating internally
whether the public should have access to the vaccine once there are sufficient
supplies, sources said.
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- But Thursday, the government's top health officials said
the discussion should be taken to congressional hearings and town hall
meetings across the nation, to get public input on a topic with sweeping
implications.
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- "I think it would be productive and healthy to have
an open dialogue," Fauci said.
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- The Sept. 11 attacks and the anthrax mailings have heightened
worries about a bioterrorist releasing smallpox. Because many people have
never been vaccinated, it would be an attractive bioweapon.
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- Although there is no evidence that such an attack is
imminent, government officials have been seeking to secure a civilian stockpile
of 286 million doses -- enough to vaccinate the entire U.S. population
in the event of an outbreak.
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- Vaccine Available
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- The government already has 15.4 million doses, which
can be diluted up to five times, producing 77 million effective doses,
according to two studies published Thursday by the New England Journal
of Medicine.
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- The stockpile will include a 155 million-dose order from
BioReliance of Rockville, Md., and an earlier 54 million-dose order with
the company, which Fauci said should all be available by year's end.
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- The government is also negotiating to buy at least 70
million doses recently discovered in a drug company's freezers. If that
supply can be acquired quickly, and holds up to dilution, it is conceivable
there will be enough vaccine for every American soon.
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- "Now we have to have the discussion of how aggressive
we recommend vaccinating this country," said Dr. Martin Fenstersheib,
Santa Clara County's health officer. "And we have to be very cautious."
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- While the smallpox vaccine rarely produces severe side
effects, when it does, they can be fatal. People with AIDS, eczema or organ
transplants would be most likely to suffer serious consequences and would
be encouraged not to receive vaccination.
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- But even in healthy adults, headaches, fever, muscle
aches, chills, nausea, fatigue and rashes are common during the first two
weeks after inoculation, according to one of the new studies, carried out
by researchers at Saint Louis University. While those side effects were
considered minimal, a third of the more than 675 people who got the vaccine
missed work, school, sleep or recreational activities because of it.
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- "This is a particularly dangerous vaccine compared
to those we use routinely," said Dr. Edward W. Campion, senior deputy
editor of the New England Journal of Medicine.
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- Death Estimate
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- The death rate for smallpox vaccination in healthy adults
is about one per million, meaning an estimated 180 people would die if
all American adults were vaccinated. Many more people with compromised
immune systems such as AIDS patients would also die if they received the
vaccine.
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- While tragic, this is fewer than the number of Americans
killed in car wrecks every two days. And it is far fewer than the hundreds
of thousands of people who would likely die if an outbreak occurred in
America and the population wasn't immunized.
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- "I see many benefits and small risks," said
Dr. Bill Bicknell, a professor of public health at Boston University School
of Public Health, who is calling for a nationwide vaccination campaign.
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- Every person infected with smallpox could conceivably
spread the disease to as many as 20 or 30 other people, who would in turn
quickly spread it to others, Bicknell said. Containing the disease by vaccinating
the public only after an outbreak occurs would be chaotic, short-sighted
and nearly impossible, Bicknell said.
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- Bioterrorism experts believe smallpox would be a weapon
of choice because it is so easily spread, undetectable until days after
an attack with no known cure.
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- While health departments across the country have been
scrambling to prepare for such a possibility, only one-fourth have bioterrorism
preparedness plans in place, according to Tom Milne, executive director
of the National Association of County and City Health Officials.
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- Administering hundreds of thousands if not millions of
doses on an emergency basis would be a logistical nightmare if a smallpox
outbreak were to occur now. Many experts believe administering the vaccine
over time on a voluntary basis would be much easier.
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- "We're not ready, although the degree of readiness
varies from community to community," Milne said.
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- Contact Julie Sevrens Lyons
at jlyons@sjmercury.com or (408) 920-5989.
- Contact Lisa M. Krieger at
(408) 920-5565.
- http://www.bayarea.com/mld/bayarea/news/nation/2957038.htm
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- Comment
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- From Alan Ritter
4-3-2
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- I just finished reading the article on the impending
smallpox vaccinations and the possible fallout from this. I would like
to point out, in fairness of course, that the "threat" comes
from two places and two places only (according to the U.S. government):
the U.S. Government and the Russian Government. According to the US government,
the two governments are the only people or places that have the virus at
all, in large quantities I might add. HUGE. So, it stands to reason that
if an "outbreak" occurs it is either our own people that are
responsible or the Russians. No Al Queda zealot has it. They just can't
have it, where would they have got, Walgreens?
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- This fact was not covered in the article at all? Why
did they not report that the only stockpiles of the "eradicated"
virus are stored within the confines of the Military Industrial Complex
(no conspiracy stuff here, this is their own propaganda spewed forth after
last September)? Why do they have it, and a lot of it? If we wiped it out
over the last 30 years, ( I personally have a scar to prove I was hit with
the vaccine) why do we suddenly, now, need to protect us against it? Why
not simply just take our STOCKPILE and trash it, and ask the Russians to
do the same? And end it all like civilized people.
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- The answer to this question might be found if one digs
a little deeper then the press releases coming from the government itself.
MONEY. Look there first. Who stands to profit from a mass vaccination and
how much will they stand to make? It won't be free, either we will be forced
to pay for it on our own, 100 million doses at say 50 dollars a piece for
"life saving piece of mind" or some propaganda like that, do
the math. That is all profit. You also mentioned that many will die, check
to see who will die (add up those who are at risk, elderly and AIDS folks
and others, how about cancer stricken folks on heavy chemo therapy who's
immune systems are shot to pieces already), your total will be a lot more
than 180 and whose parents or children are going to be the ones chosen
to die for the good of all? Who, knowing they are at risk from taking the
vaccine, will be asked to do it anyway? Further, who is going to deal with
all the sickness resulting from this? A standard flu outbreak taxes the
local hospitals and Dr.'s offices' as it is, this will positively break
the system.
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- "Reporters" need to do a bit more "reporting"
and less shilling for the pentagon. This is what I came up with, just reading
what was logically missing from the article. I didn't look into anything.
Please people, do a bit more leg work here. The rule you reporters seem
to ignore, which should be the first rule followed these days is, "Who
Stands To Profit From This." After that is established, then things
will be clear. The next rule should be, get off your ass and do some real
leg work.
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- Cheers, ADR
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