Posted on 04/06/2002 8:46:02 AM PST by Lancey Howard
Smallpox Vaccine Is Here: Now What?
Americans May Be Asked to Roll Up Their Sleeves By Daniel DeNoon
WebMD Medical News
March 28, 2002 -- Most Americans appear willing to roll up their sleeves to fight terrorism. But what if it means getting the smallpox vaccine?
Smallpox is the most feared of all possible biological weapons. The chances of a smallpox attack are small. The impact of such an attack would be terrible almost beyond imagination. There's only one sure defense -- smallpox vaccination.
If nearly all Americans got the vaccine, a smallpox attack would be pointless. There's just one problem. Nobody has ever died of a smallpox attack, but the vaccine kills one in a million people. If everybody in the U.S. were vaccinated, about 180 people would die and thousands would have bad reactions.
Are we willing to pay that price? Editorials in the April 25 issue of The New England Journal of Medicine (NEJM) say there should be open public debate -- followed by decisive action. One of these editorials is by William J. Bicknell, MD, MPH, founder of the Boston University School of Public Health and former commissioner of the Massachusetts state health department.
"The decision people have to make is this: 'Do I think after Sept. 11 that there is big enough risk of a terrorist attacking this country with smallpox that I want to do something about it to protect myself and my family?'" Bicknell tells WebMD. "But there is some cost to that -- a very small risk of dying. It is a real risk, but no greater than the risk of dying in a car accident every time you drive to work."
Until now, there wasn't enough smallpox vaccine for this to be a real choice. Things are changing:
* A pharmaceutical company has found 70 to 90 million "misplaced" doses, adding significantly to the 15.4 million doses now in the U.S. stockpile.
* New studies appearing in the current issue of The New England Journal of Medicine show that each dose of the vaccine remains effective even if watered down to create 10 times as many doses.
* The U.S. will buy 155 million doses of a new vaccine now being rushed into development.
That solves one problem. Now there's another. What should be done with the vaccine? Current strategy, developed by the CDC during the days of vaccine shortage, says hold on to vaccine supplies and wait. If there were an attack, public health officials would rush to the scene and vaccinate a ring of protection around every infected person.
Bicknell -- and another editorial by Anthony Fauci, MD, head of the National Institute for Allergy and Infectious Diseases -- wonders whether that plan could work. If multiple terrorists struck in several different U.S. cities, it would be nearly impossible to surround the epidemic. Moreover, Bicknell says, the CDC plan is based on the hope that an infected person would infect only one or two others. In previous European smallpox outbreaks in the 1970s -- in places where many people already were vaccinated -- each patient spread the disease to 11 to 38 others.
Fauci's editorial calls for "an open and public dialog" to inform the public of the advantages and disadvantages of widespread vaccination. Jeffrey M. Drazen, MD, editor-in-chief of the NEJM, strongly agrees. He says there should be public statements by experts in public health, military intelligence, and law enforcement.
"The American people would like to have a clear argument of the pros and cons," Drazen tells WebMD. "Both arguments are very strong. It would be good to say we now have enough vaccine for everybody, and that it's now possible to vaccinate a large number of people. On the other hand, the ring strategy may still be the best. I can't predict what the answer is going to be, but there should be a re-evaluation of our policy."
Drazen says elected officials should make the decision on whether to keep the vaccine for emergencies or to make it publicly available. Bicknell disagrees.
"I think this is a decision where experts should participate, but the decision should be up to each individual," he says. "Experts should tell us whether this is a safe and effective vaccine. The risk assessment should be made by individuals and families."
Medically Reviewed
By Dr. Gary Vogin
© 2002 WebMD Inc. All rights reserved.
This article makes it sound less like Americans will be "asked" to roll up their sleeves, and more like Americans will be "commanded by government" to roll up their sleeves.
There is also a concept known as herd immunity, in which x number of vaccinated individuals will limit an outbreak of a disease in a general population above the x that are vaccinated.
Don't know how that will play out in this situation
If you've ever seen a victum, you'd roll up your sleeve too.
The CDC and others continue to say that "smallpox has been eliminated from the world", but that was never true.
Stocks were maintained in Moscow and Atlanta, specifically for biowar and/or biodefense purposes.
Knowing this to be true, it was an act of staggering irresponsibility to create the largest unimmune population to smallpox in human history (Americans under 30).
I favor universal vaccination. Anyone who doesn't want it-fine.
Government and AMA...not believable.
Vaccine manufacturers see the dough in this scheme to be sure. Will the vaccine be contaminated with thimerosal? Good question.
I was vaccinated as a child, it has now worn off.
If I knew I had smallpox, I'd instantly blow my brains out. Not a nice way to go. Trust me on this.
--Boris
P.S. If you want something to really scare you, look up "SV-40" or "SV40" or "SV 40" on google.
Longer then that. If you have that little circular scar on your upper arm, that is the scar from the small pox vax. I was born in 72, I think they stopped it right before I was born, since I don't have one.
I looked it up and it really scares me.
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