One in a million recipients is likely to die
Dr David Brown, PHLS
Posted on 05/29/2002 4:34:49 PM PDT by Gritty
US researchers are warning people vaccinated against smallpox as children that they are unlikely to still be protected.
Smallpox was eradicated in the mid-1970s, but researchers warn bioterrorism fears mean mass vaccination should now be reconsidered.
But experts are divided over whether research, featured in New Scientist magazine, mean there should be a renewed mass smallpox vaccination programme.
In tests, doctors from Maryland found only 6% of over 600 microbiologists who were being re-vaccinated in the late 1990s were still immune to smallpox from their earlier vaccinations.
One in a million recipients is likely to die |
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Dr David Brown, PHLS
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In America, around 60% of the population has had a smallpox vaccination, but most will be just as susceptible to smallpox as the 120m born since the government stopped the vaccination programme in 1972, the researchers say.
Britain also stopped its vaccination programme in the early 1970s.
Lack of protection
Michael Sauri, director of the Occupational Medicine Clinic in Maryland said: "The study is, to the best of my knowledge, the only one since eradication which tries to look at the durability of immunity.
"It's showing us that after 20 years immunity is not going to be there."
Bill Bicknell of Boston University, a former commissioner of the Massachusetts Department of Public Health thinks the Maryland research backs up his view that there should be mass smallpox vaccination.
He believes it is necessary in case terrorists use smallpox in attacks.
"It adds to the argument that you can't count on any protection we thought we had," he said.
"I'm not saying you just go straight in and vaccinate the population - you'd do it steadily in stages."
He recommends healthcare workers should be first, followed by volunteers screened to check they're healthy.
But many argue against mass vaccination.
Uncertain risk
Like many other countries, Britain currently prefers "ring vaccination", where only people in the area of an outbreak and people they are in contact with are immunised.
Dr David Brown, director of the UK's Public Health Laboratory Service Virus Reference Division, told BBC News Online: "It's generally agreed that you've got almost complete protection against smallpox if you were vaccinated in the last three years, but it decreases from that time.
He said the arguments around vaccinating because of bioterrorism fears centred around the risk of a smallpox attack contrasted with the risks associated with mass immunisation.
"What we're not certain of is what the risk of a bioterrorist attack is. There is a risk, but it's never been well defined."
"And if we did go for mass vaccination, we would have to go for multiple vaccination - every three to five years - for full immunity."
He added: "One in a million recipients is likely to die, and that's without considering cases infected with HIV."
Illness rates, he said, would be even higher.
The Maryland research was also published in Maryland Medicine.
The risk of dying from natural spread of smallpox is indeed less than the chance of dying from the vaccination. Obviously, he's weighing the chance of a terrorist strike using the disease, in which case the odds change quite a bit. Ring vaccination, given modern travel speeds, is unlikely to work, as I understand it.
However, I have to agree that there is a middle ground between banning the vaccine and a mass inoculation. Let people decide. Heck, if the government wants to encourage it, they can subsidize the price some, or not. Having a percentage of the population immune will actually bring benefits in slowing the transmission of the disease, thus benefitting everyone. And this way, each person gets to decide for themselves whether they think it's worth it.
Drew Garrett
Nope - you got smallpox, but the dz was usually not as terrible. Hey if you're going to get it anyway. . .
That technique is called variolination. It has about a 1% death rate and considerably milder symptoms compared to inhaling smallpox (the normal method of contracting the disease).
I disagree when it comes to smallpox. The nature of the dz is such that those who come into contact with a contagious person have two weeks before they themselves become contagious. An announcement could be made and people who knew they were in contact with the contagious person could come to a hospital and get a vaccination.
Older people (30 or older) who had been vaccinated decades before the outbreak only had fatality rates of 5% versus the 50% fatality rate of the unvaccinated in the same age group. In addition, the severity of the disease is considerably reduced in those vaccinated.
For those younger than 30, vaccination reduced fatalities to essentially zero. Among the unvaccinated, ages 0-4, 50% fatality, ages 5-14, 10%, ages 15-29, 13%. Again the severity of the disease in the vaccinated is considerably reduced compared to those unvaccinated.
Essentially, an attack with standard smallpox will leave the United States badly hurt, but not fatally, and with a population that is very likely to know someone who died or can just look in the mirror for a reminder of what happened (IIRC, one Discover channel program noted that 75% of the portraits from 18th century and earlier should have the people bearing the marks of smallpox, the artists just left them out).
The rest of the consequences are left as exercise.
We should make absolutely sure that there is sufficient vaccinations available in the event of an attack though.
You're right. My mistake... :o)
Where are you guys coming from with this? I was vaccinated before I began the 1st grade, I was vaccinated when I went into the Maritime Service, I was vaccinated when I went into the Navy and I was probably vaccinated at least a half dozen times in all my years of going to sea!
I have NEVER heard of anybody dying or even getting sick from this immuninization. The first time, you will get an itch at the site that will drive you nuts, but nothing more. After the first time, you get no reaction.
So where does this info come from that there is a risk of death from this?
There has been no resurgence in smallpox.
Why people choose to broadcast their idiocy is always a mystery....
I'd like to see a source for your information.
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