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 ...
You seem knowelegable about this. Could you explain to me why the reactions to the DryVax would be the same as the Smallpox vaccine? I keep remembering swine flu for some reason, when I think about this.
Natural: 7-15 day incubation period (typically 10-12 days), 40-60% morbidity (40-60% of those exposed will contract it - say an average of 50%), 10-30% of those who contract it will die assuming enough medical care to keep them from dying of something else (20% average lethality).
Enhanced weaponized: 1-5 day incubation period (typically 3 days), 60-90% mordidity (average of 75%), 30-50% lethality (average of 40%).
So weaponized smallpox is about 50% worse than that found in nature and worse, its incubation period is only about three days. The latter means that vaccination won't save you if you've already been exposed. This stuff is a fucking disaster!
I found it interesting that those treated by chemotherapy are not eligible for the vaccine due to a weakened immune system.
Sure is ironic, how chemo can help treat cancer, but is a detrement when it comes to smallpox.
Ebola = virus. Antibiotics to not treat/prevent viral diseases.
Check this out .. and here's the URL: Botulism Study
"Botulinum Toxin as a Biological Weapon ............
.........Objective The Working Group on Civilian Biodefense has developed consensus-based recommendations for measures to be taken by medical and public health professionals if botulinum toxin is used as a biological weapon against a civilian population.
Participants The working group included 23 representatives from academic, government, and private institutions with expertise in public health, emergency management, and clinical medicine.
Evidence The primary authors (S.S.A. and R.S.) searched OLDMEDLINE and MEDLINE (1960–March 1999) and their professional collections for literature concerning use of botulinum toxin as a bioweapon. The literature was reviewed, and opinions were sought from the working group and other experts on diagnosis and management of botulism. Additional MEDLINE searches were conducted through April 2000 during the review and revisions of the consensus statement.
Consensus Process The first draft of the working group's consensus statement was a synthesis of information obtained in the formal evidence-gathering process. The working group convened to review the first draft in May 1999. Working group members reviewed subsequent drafts and suggested additional revisions. The final statement incorporates all relevant evidence obtained in the literature search in conjunction with final consensus recommendations supported by all working group members.
Conclusions An aerosolized or foodborne botulinum toxin weapon would cause acute symmetric, descending flaccid paralysis with prominent bulbar palsies such as diplopia, dysarthria, dysphonia, and dysphagia that would typically present 12 to 72 hours after exposure.
((NOTE: diplopia = double vision; dysarthria = a motor speech disorder; dysphonia = neurologic voice disorder that is characterized by jerky, strained, strangled and sometimes unintelligible speech; dysphagia = difficulty or discomfort when swallowing.)
Effective response to a deliberate release of botulinum toxin will depend on timely clinical diagnosis, case reporting, and epidemiological investigation. Persons potentially exposed to botulinum toxin should be closely observed, and those with signs of botulism require prompt treatment with antitoxin and supportive care that may include assisted ventilation for weeks or months. Treatment with antitoxin should not be delayed for microbiological testing.
JAMA. 2001;285:1059-1070 This is the fourth article in a series entitled Medical and Public Health Management Following the Use of a Biological Weapon: Consensus Statements of The Working Group on Civilian Biodefense.1-3 This article is the only one in the series to feature a biological toxin rather than a replicating agent.
Botulinum toxin poses a major bioweapon threat because of its extreme potency and lethality; its ease of production, transport, and misuse; and the need for prolonged intensive care among affected persons.4, 5 An outbreak of botulism constitutes a medical emergency that requires prompt provision of botulinum antitoxin and, often, mechanical ventilation, and it constitutes a public health emergency that requires immediate intervention to prevent additional cases. Timely recognition of a botulism outbreak begins with an astute clinician who quickly notifies public health officials.
Botulinum toxin is the most poisonous substance known.6, 7 A single gram of crystalline toxin, evenly dispersed and inhaled, would kill more than 1 million people, although technical factors would make such dissemination difficult. The basis of the phenomenal potency of botulinum toxin is enzymatic; the toxin is a zinc proteinase that cleaves 1 or more of the fusion proteins by which neuronal vesicles release acetylcholine into the neuromuscular junction.8 ...."
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.
"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."
Where did you read that??? On that same whack job website you posted from earlier? The CDC and other sources say that you're wrong on that score. Ever see pictures of a smallpox victim? Are you willing to bet your vaccine is still effective with that as the ante?
President Bush deserves our support on this. I'll bitch and moan and complain every single time I think he's caving to the dims on their social agenda, but I'll never give an inch of ground to anyone who claims that W is anything less than an honorable, decent and good man who has the best interest of his country at heart...period.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.