Posted on 07/07/2002 3:14:48 PM PDT by PatriotReporter
Experts Urge Mass Vaccination for Smallpox Attack
WASHINGTON (Reuters) - Mass vaccination would save thousands more lives in a smallpox attack than the current limited strategy that has been recommended to the U.S. government, experts said on Sunday.
In a study criticizing the limited vaccination plan, they recommended federal officials be ready to vaccinate millions of people.
"Mass vaccination really leads to fewer deaths than the CDC (Centers for Disease Control and Prevention ( news - web sites)) interim plan," Lawrence Wein of the Massachusetts Institute of Technology ( news - web sites), who worked on the study, said in a telephone interview.
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," possibly spreading the disease even more widely.
Wein and Edward Kaplan of Yale University, both experts in modeling epidemics, published their study in Tuesday's issue of the Proceedings of the National Academy of Sciences ( news - web sites) and urged the CDC to change its current policy when it issues new guidelines later this year.
Smallpox, once a scourge that killed nearly a third of its victims and scarred the rest, was eradicated in 1979. But some countries, including Iraq and the former Soviet Union, experimented with the virus as a potential germ warfare agent.
Fearful of a smallpox attack, the U.S. government last year ordered millions of doses of smallpox vaccine -- enough, in the words of Health and Human Services ( news - web sites) Secretary Tommy Thompson, to vaccinate "every man, women and child" in the country.
PLANS FOR VACCINATING 500,000 REPORTED
Government advisers last month said a so-called ring vaccination strategy, which would involve finding and vaccinating people who had contact with an infected person, would probably be sufficient in case of an attack. More people could be vaccinated if this approach failed, they said.
They also recommended vaccinating potential first-line responders now as a precaution. On Sunday, The New York Times reported the federal government was planning to vaccinate 500,000 health care and emergency workers soon.
The newspaper quoted federal officials as saying the government was laying plans for a mass vaccination of the population, just in case.
But a U.S. Health and Human Services Department spokesman, Bill Pierce, told Reuters the exact number of those to be vaccinated had not yet been decided.
Pierce said these recommendations were very general and required more work by HHS and the Centers for Disease Control to identify which groups should be vaccinated.
The ring vaccination policy was used in the 1970s to eradicate the virus, which lives only in people, in the last few places where smallpox infection remained.
Kaplan said current policy is based in part on this past success.
"But it is one thing when ring containment means putting a ring around a village ... as opposed to trying to put a ring around New York City," Kaplan said in a telephone interview.
Kaplan and Wein ran a computer model of what would happen if someone used a smallpox weapon against a city of 10 million people. Kaplan told an advisory meeting on smallpox vaccine that an initial 1,000 infections could lead to 97,000 deaths.
SIDE-EFFECTS
Ring vaccination would lead to 4,000 more deaths than mass vaccination would, they predicted -- even taking into account a high rate of side effects from the vaccine.
"We tried to take into account the likely number of people that you would have running around tracing and vaccinating," Kaplan said in a telephone interview.
"What if you can't identify everybody?" People can be ill with smallpox and pass on the virus before they develop the distinctive blisters, Kaplan pointed out. "The disease doesn't stand still and wait for you to intervene."
Since vaccination was scrapped in the United States in 1972, experts assume almost no one has any real immunity any more. This means smallpox, which is highly infectious, could spread like wildfire through the population.
But the current vaccine is based on old technology and is not considered very safe. It has a high rate of side-effects, some of them deadly.
In addition, more people have suppressed immune systems now than in the 1970s, and they could be at special risk not only from the vaccine, but from people recently immunized with it.
Such people include cancer patients being treated with chemotherapy and people infected with the AIDS ( news - web sites) virus.
The current CDC policy, endorsed by the Advisory Committee on Immunization Practices last month, takes this into account. It calls for quarantining anyone confirmed to have been infected in a smallpox attack.
Anyone who may have had contact with the infected patients would be tracked down and vaccinated
Many vaccines that we routinely inject into infants are doing more harm than the diseases against which we are trying to protect. When confronted with the facts, "health officials" always shrug, it seems, and have no answer. It's part of the lunacy that has become modern medicine.
There IS a sticky problem with one of the smallpox vaccines, though. I don't recall what the name of the particular vaccine is, but there have been cases of babies dying after contracting a disease carried by recently vaccinated adults (must be a live-virus vaccine). Similar cases are known involving the polio vaccine.
Nonetheless, debate could go on for ever, and vaccines should not be mandatory, nor witheld. I think people should always seek out solid information about any vaccine they get, or their children get, though.
There are several vaccine monopolies which the Clinton era permitted in our nation. Most notably, Wyeth Pharmaceuticals obtained patent rights to produce Rotashield and Prevnar. Both vaccines were added to the ACIP recommendation list in record time. It took ACIP 20 years to decide to immunize American children for Chicken Pox (because the manufacturer and researchers were Japanese?????). It took about probably just over 20 months for Rotashield and Prevnar to make it through the approval process!
Rotashield didn't last very long on the open market. Studies began to show that intussusception was occurring in babies who received the vaccine (which was for a very common and horrible stomach virus called Rotavirus). Wyeth recalled and then terminated the vaccine production.
Prevnar is a different story. Wyeth has a total monopoly on this vaccine and it is the most expensive product on the ACIP list of recommended vaccines.
ACIP makes "recommendations". However, for most physicians these ACIP "recommendations" are "mandates". This is due to the prior court precedence that a physician is responsible for malpractice if a person contracts a vaccine preventable disease. Several courts found that a physician was liable for pain, damage, and suffering for not giving a child a "recommended" vaccine... even when the parent refuses the vaccination. There are some physicians who have addressed this issue by having parents sign legal waivers which clarify that the physician has made several attempts to vaccinate and the parent refuses.
So, although ACIP does not "mandate" mass vaccination, there is a defacto standard of care in any decision from ACIP. ACIP is composed of physicians who are nominated to serve on the committee from the American Academy of Pediatrics and the American Academy of Family Practice. Ironically, there is no membershp from the American College of Internal Medicine. Also interestingly, the AAP gets millions of dollars of donations from (you guessed it!) vaccine manufacturers.
I am not familiar with Dynport's prior track record. Until you posted this message, I hadn't been able to identify the various vaccine production channels in our nation. I have been attempting to identify those factories for some time. Wyeth used to have the prior smallpox vaccine called DryVax.
Given Wyeth's recent poor track record, I am not disatisfied with the Phase 1 trials just being started on the DynPort smallpox vaccine.
I'm interested in seeing existing stockpiles of vaccine distributed now. Delays are not appropriate, especially if the rumors of likely conflict in Iraq are true.
LOL! I know just enough about this business to know that there are too many important details in vaccine manufacturing (out of which any number of wild claims could be generated) for me to have a fully formed opinion (I do have suspicions). With regard to anything as serious as smallpox, I just don't like government funded monopolies any more than I like putting my retirement into a single investment. I have more too much faith in Murphy's Law and too much experience with manufacturing to Mil-Spec to think that it's a smart policy.
If there is "population reduction" conspiracy, (as there might well be among the Popular Front CommunoFascist UN/Club of Rome monsters such as Maurice Strong), well, I do wish I could innoculate a cow or two. Other than that, one's choices are indeed limited.
I wonder how much of this "debate" is being fueled by the inevitable malpractice/lawsuits that would result in the event of mass vaccinations.
I wonder how much of this "debate" is being fueled by the inevitable malpractice/lawsuits that would result in the event of mass vaccinations.
If the federal government orders a mandatory mass vaccination, I don't think that any physicians should held liable for any side effects of the vaccine. The federal government should be required to be liable.
The 1 in 3 probability of death is for the wild varieties of smallpox that are extinct. If smallpox were to be used as a biological weapon by terrorists, it probably would be based on the variety of smallpox isolated by the Soviets in India in 1967. This variety evolved in the crowded evironment on India, and the Soviets had a stockpile of twenty tons of it. It had a 50% mortality rate.
See, I don't even agree with that. It may sound heartless, but "stuff" happens. We have to weigh the greater good of everyone, and I don't think the federal government should be held liable. When the Polio vaccine was first fielded, there were several citizens who contracted Polio from the vaccination, all manufactured by the Cutter company, I think. It was a big controversy at the time -- but the success of the vaccine has made (I hope) polio a forgotten disease. Just to think of the once common diseases we have eradicated is incredible. Smallpox, whooping cough, Tetanus, Syphylis, Gonnorhea (both incurable before the advent of pennicillin, the AIDS of the day) German Measles... 20 million people died as a result of the Flu just after world war I, fer cryin' out loud!
What really steams me, is after years of hard work and dedication, we throw away a lot of our natural immunity to this by (yes) letting illegal immigrants in the country with no idea of their disease status is, politically "correct" treatment of certain disease carriers, etc. etc.
No, that should be decided by people a lot smarter than I am. I just hope that politics doesn't get involved.
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