Posted on 10/05/2002 6:34:56 PM PDT by bonesmccoy
WASHINGTON, Oct. 5 — The Bush administration’s top bioterrorism advisers said yesterday they support a voluntary smallpox vaccination program that would begin with 500,000 health care workers, expand to 10 million emergency responders and extend to the rest of the population as early as 2004.
IT WAS THE first time high-ranking administration officials acknowledged they are considering offering the risky vaccine to the public prior to an attack and it represented a profound shift in thinking from the June recommendations of a government advisory panel to inoculate about 20,000 medical personnel.
“We live in a society that values individual choice,” said Julie L. Gerberding, director of the Centers for Disease Control and Prevention. “If we have vaccine and we have data to accurately assess the safety, one school of thought is that informed people may want to have the choice of getting vaccine or not.”
In a 90-minute briefing at the Department of Health and Human Services, the group of officials responsible for implementing a bioterror response plan laid out the options before President Bush, stressing that he has yet to make a decision on who could be vaccinated and when. If a smallpox case were detected, officials would assume the nation was under attack and would quickly move to nationwide vaccination.
Developing a “pre-attack” vaccination policy, however, has proven to be “extremely difficult” because of the challenge in balancing the possible risks of the vaccine against the risks of an attack, said Jerome M. Hauer, assistant secretary for emergency health preparedness.
THREAT OVERCOMES CONCERNS
Although they have no way of knowing the likelihood of a smallpox attack, health experts fear such an attack because the virus is so contagious and so deadly. About one-third of people who get the disease die, yet the vaccine itself can cause serious, sometimes fatal, complications.
Concerns that Iraq or another hostile nation may have acquired the virus have added urgency to the vaccination debate. “We need to be mindful that the context of this decision has changed a bit” since the far more conservative June recommendations, Gerberding said.
Vice President Cheney has speculated that the threat from Iraqi President Saddam Hussein may necessitate mass vaccination. Privately, sources said Cheney has vigorously advocated a broad vaccination policy. White House spokesman Scott McClellan said last night the policy “is under review” but he could not elaborate on a timetable or factors involved in the decision.
Since last fall’s anthrax attacks, federal health officials have moved swiftly to build up the nation’s smallpox vaccine stockpile. If an attack occurred today, they said they could safely dilute the existing supply to inoculate every American. By the end of next year, they expect to have 209 million doses of new vaccine on hand. None of the vaccine has been licensed by the Food and Drug Administration, but officials expect the first batches will be approved by November.
MILITARY FIRST IN LINE
At the request of the Department of Defense, Hauer said HHS will provide the first 1 million doses of licensed smallpox vaccine to the military within the month. Pentagon spokesman James Turner refused to comment.
For civilians, the HHS team favors a policy of “ever-expanding access to vaccine” that could be phased in as more vaccine is licensed and scientists have time to monitor early reactions to it. Using licensed vaccine would be much easier logistically than administering it as an experimental treatment that involves tricky liability issues.
The approach envisions vaccinating the people considered to be at greatest risk if an outbreak occurs. That would include public health investigators, emergency room workers and even janitors and security guards at local hospitals.
The goal in the early stages, Gerberding said, “is to maximize our ability to respond to an attack should one occur.”
In the second phase, as many as 7.5 million medical workers would be offered vaccine, along with the nation’s 3 million firefighters, police officers and rescue workers, Hauer said. Inoculating that many emergency personnel “would make it even easier to respond” to an attack, Gerberding explained. It is possible Bush would combine the first two phases and opt to inoculate the majority of first responders immediately.
At some later date, perhaps in early 2004, vaccine could be offered to every American. “Right now, our thinking is in favor of making vaccine available to the general public,” Gerberding said.
Federal health officials rejected the advice of its advisory panel to designate certain smallpox hospitals because Hauer said it was unrealistic to think patients would follow those guidelines.
America stopped routine vaccination in 1972, which means about 45 percent of the population has never been inoculated. It is unclear how much immunity remains from vaccines given 30 or 40 years ago.
Between 30 million and 50 million Americans should not be given the vaccine because they have weak immune systems, said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. That includes people who have received chemotherapy, have eczema or are infected with the AIDS virus. For every 1 million vaccinated, 15 people are likely to suffer life-threatening complications and one or two would die.
Because there is limited scientific data, it is difficult to predict the risks of a person spreading the virus in the vaccine to others. Administration aides are still grappling with the liability issues of reviving a vaccination program.
State health officials have until Dec. 1 to file plans for mass vaccination within five to 10 days of an attack, Hauer said. In the event of an attack, he observed, “Five days might be a luxury.”
(Excerpt) Read more at msnbc.com ...
Another interpretation, which I have suggested, is that the remote, hypothetical smallpox threat makes a convenient cover story or stalking horse for rolling out civil defense measures against the very concrete threat presented in the anthrax letters, and presented by Saddam Hussein's known heavy investment in anthrax as a poor man's alternative to nukes. I don't want to oversell this, because I think the first interpretation is arguable, but I couldn't help but be amused by the CDC director's apparent freudian slip during the interview, substituting "anthrax" for "smallpox." It does fit with my idea that their is a disconnect between what these people are worried about behind the scenes, and the comfortably hypothetical proxy threats they talk about in public (smallpox, suitcase nukes, dirty nukes, etc.)
Well, the government also put in an order for 100 million doses of Cipro after the anthrax attacks of last year, so that's in the stockpile already (U.S. buying 100 million doses of anthrax antibiotic). The problem is that it is generally very easy to add antibiotic resistance to bacteria -- it doesn't require sophisticated genetic engineering, just routine lab techniques -- so it's all too possible that they only used antibiotic-susceptible anthrax for the warning letters for operational reasons, i.e. to protect the senders from accidental death and subsequent exposure. I bought 60-day supplies of Doxy and Cipro after the anthrax scare, but I honestly don't have that much faith they would be much help in a real attack. The anthrax vaccine has a completely differnt mode of action and probably would save a lot of lives -- if we can put in place the infrastructure to deliver it to millions of people in a very short space of time and if we can figure out how to avoid complet, Panic in the Streets-style social disintegration when the news hits of the first few hundred people checking into St. Vincent's with respiratory problems. Those are big ifs, IMO.
This is not to say that al-Qaeda is not dangerous. In the first place, the establishment of an "Assassination Bureau" of would-be suicidal human missiles, ready to be contracted out to generic anti-Jewish and anti-American missions, is a revolutionary military development. Mate these suicidists to low-tech, biological WMD, and you have something every bit as revolutionary as the nuclear-tipped ICBM. In the second place, the impressive discipline and economy of means demonstrated in the 9/11 attacks may educate and inspire them to higher things. (Note, however, that the Islamists will never learn how to build jet airliners and skyscrapers -- there are limits to the "monkey see, monkey do" principle.) But, I think we need to get real: these people did not go from being a ragtag bunch of miscreants to an efficient, hyper-intelligent mobile fighting force overnight. They are still dorks. But smart people can build great empires on the backs of dorks, after all. Our real concern should be the "brain bug" in Baghdad, not a bunch of wankers living in a bedsit in Joisey.
Does this mean that someone in the United States or Russian government couldn't use the virus for a direct attack? Without going through terrorists as a third party? It would be so easy for either government to launch an attack and avoid repurcussions by just blaming it on faceless terrorists.
How so?
I don't know the answer to that question. 1-3 days would be my stab-in-the-dark guess. Part of the problem is that the efficacy of any post-attack treatment, whether it be a vaccine, an antitoxin, or an antibiotic, is going to drop off the longer after the attack it is given. That means that, after an attack, everyone is going to be very conscious that it's a race against time, and a race against the other fellow, with literally life-and-death stakes. I really don't see any way around that, unless the meds can be pre-distributed, but I've never seen any sign of willingness to do that. The authorities have always gone out of their way to discourage people from acquiring medications prospectively. Of course, that may change when a showdown with Saddam is in the offing. Perhaps there is some kind of intermediate solution. For example, if we have enough stocks on hand, they could be distributed to every corner drug store, so that everybody could have some reasonable assurance of getting treatment promptly. They'd have to self-treat, but again, as this comes closer to a climax, the necessary education steps could be taken to make that feasible, at least if the vaccine can be administered orally. That approach would also be fool-proof against any terrorist attempt to disrupt distribution (e.g. 2AM - drop anthrax on subway tracks, 10 AM - suicide attack on treatment center).
Has anyone ever proven this? I mean, has anyone ever confirmed that any nukes are actually physically missing and not just administratively lost. The same way we sometimes loose tanks or rockets?
I wonder how this was determined. Vaccinated at least a million people in a study?
No antibiotics, But flamethrowers would probably work. Call it the andromeda solution.
Under martial law, you'd probably be better off not getting found in possession of lead and brass items. Unless, maybe, you'r referring to mickey mouse statues.
There are a lot more readers than posters. The articles are for them as well. It does sort of help to indicate that the article doesn't nescessarily reflect your opinion though. For the sake of the posters who might assume otherwise.
My question here would be ... how would they know exactly what the strain was unless they had some of it? Something, I'm not sure just exactly what, is bothering me about all this smallpox vaccination stuff.
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