Washington DC plans smallpox shots for entire city

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http://www.washtimes.com/business/20021207-69458770.htm

Washington, D.C. plans smallpox shots for entire city

By Tom Ramstack

THE WASHINGTON TIMES

The D.C. Health Department is scheduled to deliver a plan to the Centers

for Disease Control and Prevention on Monday that proposes offering smallpox

vaccinations to the District's entire population within a year.

Like plans in other cities and states, the District's vaccination program

raises the possibility that smallpox vaccine will be offered to the entire U.S.

population under a policy President Bush is expected to announce in about a

week.

The policy is intended to counter the risk of terrorists unleashing the

smallpox virus on the United States. Smallpox is one of the world's most lethal

viruses. It is characterized by rash and high fever.

District health officials are coordinating their plan with similar

vaccination plans by the land and Virginia health departments.

The only undetermined issues are when the vaccinations would begin and how

many people would receive them, said Dr. , senior deputy

director of the D.C. Health Department.

" It's a foregone conclusion we are going to vaccinate people, " Dr.

said. " We expect this is going to occur. "

Pregnant women, children under 1, persons with eczema and anyone with a

weakened immune system, such as those infected with HIV or chemotherapy

patients, would be advised against getting the vaccinations.

" They have a higher likelihood of an adverse reaction, " Dr.

said.

Adverse reactions can include fatigue, body pains and itchiness. For every

1 million people vaccinated, one or two are expected to die. Between 14 and 52

others would suffer serious side effects, such as brain inflammation, according

to the CDC's historical data on smallpox vaccinations.

The emergency version of the District's plan lays the groundwork for all

eligible D.C. residents and visitors to be vaccinated within one week after the

first smallpox case is reported or by early 2004 if no cases occur.

The vaccinations for health care workers could start as soon as this month

under the " pre-event smallpox vaccination plan, " Dr. said.

Vaccinations for the general population, which would be administered at

university auditoriums, would begin in about a year and continue for as long as

120 days, he said.

Participating universities listed in the Health Department plan include

American University, Catholic University, Gallaudet University,

Washington University and University. Secondary school auditoriums might

be used if they are needed, Dr. said.

The U.S. Department of Health and Human Services is requiring the plans

from all states and major cities to prepare for a bioterrorist attack.

" The CDC has asked us to prepare plans about how to vaccinate the entire

population in case a mass vaccination was determined to be necessary, " said

Trina Lee, spokeswoman for the Virginia Department of Health.

The Virginia plan does not specify locations for administering the vaccine.

Instead, it leaves the decision to the state's 35 health district directors, who

would first consult local officials.

land health officials cited security concerns in refusing to say where

vaccines would be administered.

The land plan focuses on first administering vaccines to hospital

personnel and public health workers, which would require 6,000 to 8,000 doses,

said Black, spokeswoman for the land Department of Health and Mental

Hygiene.

" We expect to have six to 10 sites to vaccinate the public health teams, "

Miss Black said.

President Bush's announcement will determine the extent of the vaccination

program.

" The president has not made his decision, " said Gordon droe, spokesman

for the new Department of Homeland Security.

So far, the Bush administration's policy consists of " just preparation, " he

said.

In the District and the nation, the vaccine would be administered in three

phases. The first phase would be limited to hospital health care personnel and

public health workers. It would include about 3,000 to 5,000 persons in the

District.

The second phase would be expanded to all emergency response personnel,

which would be 50,000 to 100,000 firefighters, police, emergency medical

personnel and other emergency workers in the District.

The third phase would cover the general population, which Dr.

said would be about 600,000 residents and visitors to Washington.

The workers in the first two phases would receive the vaccinations at their

job sites or public health clinics. The general population would get them at the

university auditoriums.

The emergency version of the plan, which the D.C. Health Department

delivered to the Centers for Disease Control on Dec. 2, is essentially the same

as the yearlong plan, except more personnel would be working in less time.

Emergency management workers would give out food and water at the sites,

mental health workers would stand ready for emotional outbursts, and security

workers would keep order. The federal government would cover the costs.

Another event that would trigger an accelerated vaccination schedule is war

with Iraq.

" The estimation of risks and threats changes at that point, " Dr.

said. " We may need to step up our preventive strategy. "

If no emergency occurs, the first phase of vaccinations for Washington is

scheduled to be completed in 45 to 60 days, followed by phase two in 60 to 90

days, then phase three in 90 to 120 days. No starting date has been set for any

of the phases.