For those in Massachusetts:
Article Last Updated: Friday, December 24, 2004 - 7:13:21 AM EST
Study says Mass. is least prepared state to handle bioterroist attack
By Jennifer Fenn
Statehouse Bureau
BOSTON -- Massachusetts is the least prepared among all states to handle a bioterrorist attack, according to a new study.
State public health officials immediately refuted the results of the Trust of Public Health's report that ranked Massachusetts at the bottom of the heap nationwide.
Public Health Commissioner Christine Ferguson said the department does not feel the report "accurately reflects the true state of emergency preparedness" in the state.
"I am confident that the state is prepared to respond effectively to a bioterrorism event," she said in a statement.
"Ready or Not? Protecting the Public's Health in the Age of Bioterrorism -- 2004" examined key indicators to gauge state preparedness and determine the country's overall readiness to respond to bioterrorist attacks and other health emergencies.
The report ranked states based on whether they met 10 criteria. The criteria included such elements as the amount of state spending and federal aid allocated to public health, flu vaccine rates, and the number of scientists and laboratories available to test for anthrax or the plague.
The report found that despite some progress nationwide, there years after the Sept. 11, 2001 terrorist attacks, Americans are still at risk, and Massachusetts, in particular, has not made enough strides.
Over two-thirds of states and Washington, D.C., achieved a score of six or less out of the 10 possible indicators. Massachusetts and Alaska received a three out of 10, the worst in the nation.
"This report found that more than three years after 9/11 and the anthrax tragedies, we've only made baby steps toward better bioterrorism preparedness, rather than the giant leaps required to adequately protect the American people," said Lowell Weicker, president of the trust's board. "The conclusions of this study demand an answer to the big question here: What will it take to make bioterrorism and public health preparedness a real national priority?"
Fitchburg Health Director Jeff Jerszyk said he thinks the Department of Public Health has been slow to implement its bioterrorism plan due to budget cuts and understaffing.
Jerszyk said the DPH has divided the state into 16 regional planning groups, but that it was three months late this year in distributing money to those groups. But at least the state is making an attempt, he said.
"They're making an attempt, but how the money comes down is extremely difficult," Jerszyk said. "It's slow in coming, but everybody's been working on it."
According to the report, Massachusetts is one of nearly one-third of states that cut the public health budget between fiscal years 2003 and 2004. The report said Massachusetts is not adequately prepared to distribute vaccines and antidotes in an emergency, is not capable of fully responding to a chemical terrorism threat and that it does not report sufficient bioterrorism laboratory response capabilities.
The report also said Massachusetts does not electronically track diseases outbreak information by national standards, which could cause serious delays in reporting and make early warning of disease threats difficult.
Nationally and in Massachusetts, funding was a key problem.
Officials of the Massachusetts Public Health Association, the state's leading public health advocacy organization, said cuts to public health funding was the main reason Massachusetts ranked so poorly in the study.
Between 2001 and 2003, the department's budget was cut by more than $156 million, association officials said.
"At just the time we should have been investing more heavily in public health, we were tearing our infrastructure apart," said Geoff Wilkinson, executive director of the health association.
Although the state did not fare well on the trust's report, Ferguson said an "objective outside evaluation" by the federal Centers for Disease Control on objective standards of 14 critical benchmarks of preparedness found that the state has demonstrated preparedness in 12.
However, she also said the trust's report did not fully explain the state's preparedness plan. She said the report does not hold each state to the same standards. For example, whether the state public health budget increased during the past two fiscal years includes Medicaid spending for some states while others only include public health, she said.
"While we are constantly working to improve our capacity and preparedness we have made significant progress since 9/11 to protect the health and safety of Massachusetts' residents," Ferguson said.
"By a uniform and equitable measure of comparison, Massachusetts is well prepared to respond to a public health emergency."
Following FX's "Smallpox," which aired last night, my son had questions regarding whether he would be able to get vaccinated in light of his diabetes. Since it's now 3:35am over here on the east coast and he's still wide awake and pacing because he's too impatient to wait until morning when I can ask an actual human, I decided to sit his little bottom at the computer and look it up. I realize most of you probably have the information or already know but since I had to research it anyway, I thought I'd post the information on who can/can't/should/shouldn't receive the vaccination. The following information can be found at the CDC's website under FAQ's regarding the vaccination:
1. Who should NOT get the vaccine?
People who should not get the vaccine include anyone who is allergic to the vaccine or any of its components(polymyxin B, streptomycin, chlortetracycline, neomycin); pregnant women; women who are breastfeeding; people who have, or have had, skin conditions (especially eczema and atopic dermatitis); and people with weakened immune systems, such as those who have received a transplant, are HIV positive, are receiving treatment for cancer, or are taking medications (like steroids) that suppress the immune system. Also individuals younger than 12 months of age should not get the vaccine. Additionally, the Advisory Committee on Immunization Practices (ACIP) advises against non-emergency use of smallpox vaccine in children younger than 18 years of age and the vaccine manufacturer’s package insert states that the vaccine is not recommended for use in geriatric populations in non-emergency situations. The term geriatric generally applies to those people age 65 and above. These people should not receive the vaccine unless they have been exposed to smallpox. Also, people who are using steroid drops in their eyes should wait until they are no longer using the medication to get the vaccine. In addition, people who have been diagnosed by a doctor as having a heart condition with or without symptoms, including conditions such as previous myocardial infarction (heart attack), angina (chest pain caused by lack of blood flow to the heart), congestive heart failure, and cardiomyopathy, stroke or transient ischemic attack (a “mini-stroke” that produces stroke-like symptoms but no lasting damage), chest pain or shortness of breath with activity (such as walking up stairs), or other heart conditions being treated by a doctor should not get the vaccine at this time. In addition, individuals who have 3 or more of the following risk factors should not get the vaccine at this time: high blood pressure diagnosed by a doctor; high blood cholesterol diagnosed by a doctor; diabetes or high blood sugar diagnosed by a doctor; a first degree relative (for example, mother, father, brother or sister) with a heart condition before the age of 50; and/or, currently a cigarette smoker. (These may be temporary exclusions and may change as more information is gathered.) (updated Mar 31, 2003)
2. Should you get the smallpox vaccine if you have a weakened immune system (e.g., you are immunocompromised)?
No, you should not be vaccinated, unless there is a smallpox outbreak and you have been directly exposed to the smallpox virus. Vaccination can cause death in people with weakened immune systems. Thus, there is no need to take the risks associated with smallpox vaccination unless you have been directly exposed to smallpox—and even then, you should first consult a physician or health care provider. (added Nov 13, 2002)
Pregnant women are discouraged from getting the vaccine. Is there a danger to them (or to an unborn child) if broader vaccination occurs, increasing the potential for contact with vaccinated people?
Pregnant women should NOT be vaccinated in the absence of a smallpox outbreak because of risk of fetal infection. Inadvertent transmission of vaccinia virus to a pregnant woman could also put the fetus at risk. Vaccinated persons must be very cautious to prevent transmission of the vaccine virus to pregnant women or other contacts. (added Nov 13, 2002)
3. Why has CDC advised that people with known cardiac disease not receive the smallpox vaccine?
CDC has received reports of cardiac events following smallpox vaccinations. Although it is unclear whether or not there is any association between smallpox vaccination and these events, CDC recommends, as a precautionary measure, that individuals who have been diagnosed by a doctor as having a heart condition with or without symptoms should not receive smallpox vaccine at this time. These include conditions such as: previous myocardial infarction (heart attack), angina (chest pain caused by lack of blood flow to the heart), congestive heart failure and cardiomyopathy, stroke or transient ischemic attack (a “mini-stroke” that produces stroke-like symptoms but no lasting damage), chest pain or shortness of breath with activity (such as walking up stairs), or other heart conditions being treated by a doctor should not get the vaccine at this time. In addition, individuals who have 3 or more of the following risk factors should not get the vaccine at this time: high blood pressure diagnosed by a doctor; high blood cholesterol diagnosed by a doctor; diabetes or high blood sugar diagnosed by a doctor; a first degree relative (for example, mother, father, brother or sister) with a heart condition before the age of 50; and/or, currently a cigarette smoker. These may be temporary exclusions and may change as more information is gathered. The presence of these conditions in a close contact is not a reason to defer vaccination. Vaccination of other persons should be continued as planned. (updated Mar 31, 2002)
4. Are there any eye conditions that would preclude vaccination?
The concern surrounding eyes is that frequent touching of the eyes by someone who has gotten the smallpox vaccine may increase the chances that that person will experience spread of the vaccinia virus to the eyes (inadvertent inoculation of the eye) by touching the vaccine site or something contaminated with live virus and then touching their eyes before they wash their hands. This side effect is a serious one because it can lead to damaged vision, or even blindness. People who wear contact lenses, or touch their eyes frequently throughout the day can get the smallpox vaccine, but they must be especially careful to follow instructions for care of the smallpox vaccination site. Frequent and thorough hand washing will minimize the chance of contact spread of the vaccinia virus. As an additional precaution to minimize the risk of this type of transmission in selected groups of people, on January 14, 2003, the Advisory Committee on Immunization Practices (ACIP) decided that anyone with eye diseases or other conditions (e.g. recent LASIK surgery) that require the use of corticosteroid drops in the eye should wait until they no longer require such treatment before getting vaccinated. (added Jan 29, 2003)