Jerusalem, January 3. 2011 — With the current outbreak of the flu season in Israel, hospitals are reporting overcrowding, and doctors are advising people who have not yet been vaccinated against flu to get their shots.
Surprisingly, howev…
The current smallpox vaccination policy of vaccinating a very limited number of first responders to a potential smallpox outbreak and avoiding mass vaccination is the best vaccination strategy, say two smallpox experts in an article in Annals of Internal Medicine. The article is released today online at www.annals.org and will be published in the March 18, 2003, hard copy edition of the journal. In the absence of a known threat of smallpox exposure, mass vaccination of the entire population or selective or voluntary vaccination would be dangerous to many who might get the vaccine, their contacts and the public health initiative, say J. Michael Lane, MD, MPH and Joel Goldstein, MD, in the article.
Guidelines for inoculating the entire U.S. population against smallpox are being distributed to states today by federal health officials. At the moment mass vaccination is likely only if the deadly virus returns through an act of bio-terrorism. In the event of an outbreak, states would have to vaccinate their populations within days. (A person exposed to the virus can only be successfully immunized within five days of exposure.) The plan from the Centers for Disease Control and Prevention (CDC) shows states how to handle this massive effort, down to details like the number of hours a clinic would need to stay open (16), what to stress in public announcements (“urgency and patience, not panic”), the number of large-screens TVs needed per clinic (5, for video orientation), the temperature at which each brand of vaccine must be stored (varies), and the number of security personnel needed per 8-hour shift at a clinic (20). Smallpox is deadly, with a mortality rate of at least 30 percent. Because the disease was eradicated globally in the 1970s, most people have little immunity to it — and health workers aren’t familiar with it. Those facts plus the mobility of our plane-hopping poplulation mean that without extensive planning an outbreak could overwhelm public health systems.
Vaccinating hundreds of thousands of Americans would be more effective in the case of an intentional or accidental outbreak of smallpox than a more limited “ring” plan endorsed by the Centers for Disease Control and Prevention, some specialists believe. “Mass vaccination really leads to fewer deaths than the CDC interim plan,” Lawrence Wein of the Massachusetts Institute of Technology told Reuters. Besides, he said, if there were a smallpox attack, “I think it highly likely that people would take to the streets to demand vaccination, or would flee.” Of course, the smallpox vaccine could be fatal or severely debilitating for many people, including those with common skin conditions like eczema and psoriasis.