Smallpox Vaccine
Program Wasted Billions

By Christopher Snowbeck
Pittsburgh Post-Gazette
Scripps Howard News Service

In the latest sign that the nation's smallpox vaccination program has fallen short of
expectations, public health officials in several large states say they may end up throwing
away more smallpox vaccine than they have used.
Public health officials contacted in California, Illinois, Ohio, New York and Pennsylvania said
they still have plenty of vaccine. Of the combined 53,800 doses they've received for health
care workers, the states have prepared just 15,300 for use. But out of those prepared doses,
only 5,041 people have been vaccinated.
The unused vaccine doesn't represent a safety problem or even raise much of a cost
concern, but it does show a dramatic change in attitude that has taken place during the past
two years.
"The fact that the doses aren't being used is a marker of what's commonly recognized: that
the vaccine campaign failed in meeting its original objective," said Dr. Linda Rosenstock,
dean of the School of Public Health at the University of California, Los Angeles. "I don't think
(the campaign) was ever sufficiently well-justified to the medical and scientific communities
that the risk of (smallpox) exposure was so great as to warrant such an aggressive
In December 2002, President Bush announced the campaign to vaccinate public health
officials, hospital workers and emergency first responders who "could be on the front lines of
a biological attack." The plan envisioned vaccinating more than 500,000 people.
But for a host of reasons, which included the small but real risks of dangerous side effects
posed by the vaccine and concerns about who would be liable for those harmed by
vaccination, relatively few people have volunteered to get them.
The government has shipped nearly 300,000 doses of vaccine to state and local health
departments, but only about 40,000 people have been vaccinated so far. Called Dryvax, the
vaccine comes in powder form. Once a solution is added to the powder, each 100-dose vial
is good for 90 days.
Pennsylvania has received 10,000 doses, but prepared only 1,200 of them for use. Of those,
256 doses have been successfully administered. Some of the remaining 944 doses have
already expired and the remainder will expire by August.
"There's going to be some wasted," said Richard McGarvey, Pennsylvania Department of
Health spokesman.
In California, 6,400 doses were prepared, but only 1,847 people - equal to about a third of the
doses - have been vaccinated so far. In Illinois, just 291 out of 1,800 prepared doses have
been used.
While state health officials in California and Illinois suggested that at least some of their
prepared doses might still be used, their counterparts in the city of Los Angeles and in Ohio
and New York state said that their campaigns to vaccinate health care workers and
emergency responders were pretty much over.
Ohio successfully used 1,902 out of the 3,400 doses it prepared. In New York state outside
New York City, the ratio was 745 people vaccinated to 2,500 doses prepared.
The federal Centers for Disease Control and Prevention is not tracking the number of
prepared doses of vaccine and comparing them with the number used.
Some vaccine was probably wasted as public health workers learned how to administer it,
said Claire Hannan, senior director for immunization policy for the Association of State and
Territorial Health Officials. Smallpox vaccine is delivered with a bifurcated needle and public
health workers received training in its use.
Hannan and other public health officials said that the campaign should not be judged simply
on numbers.
Enough people have been inoculated to increase preparedness, said Donna Knutson, senior
adviser to the terrorism program at the federal Centers for Disease Control and Prevention.
Health departments have developed plans and capabilities to handle mass vaccinations,
should the need arise.
"There's enough doses out there that they can be administered quickly if there's an outbreak,"
Knutson said. "Preparedness means more than just having a shot in the arm - it can also
mean the vaccine is closer to the arm."
Getting smallpox vaccine into some health care workers proved useful just last month in
responding to the first-ever human cases of monkeypox in the United States.
Smallpox vaccination provides protection against monkeypox, and that meant a public health
worker in northwestern Ohio was able to safely respond to a probable case, said Jay Carey,
an Ohio Department of Health spokesman.
The spread this year of severe acute respiratory syndrome has also underscored the
importance of a health care worker vaccination program, because so many SARS victims
were doctors and nurses, said Bill Pierce, spokesman for the U.S. Department of Health and
Human Services.
Rosenstock, the dean of public health at UCLA, said, however, that the wasted doses aren't
the only waste associated with the vaccination campaign.
"The far greater waste was the amount of attention, funding and human resources dedicated
to this," said Rosenstock, who argued that government secrecy undercut the campaign.
"Medical professionals ... are used to trying to get a sense of what's the risk, what intervention
are you proposing and what are its benefits and risks, and then making a judgment," she said.
"I do think that, at the beginning, we were supposed to just take the (Bush) administration's
word that this was a serious risk."
Christopher Snowbeck can be reached at csnowbeck(at) Distributed by
Scripps Howard News Service.
Ingri Cassel, President
Vaccination Liberation - Idaho Chapter
P.O. Box 457
Spirit Lake, ID 83869
(208)255-2307/ fax 255-2607
"Free Your Mind....
From The Vaccine Paradigm"



This Site Served by TheHostPros