Posted on 10/07/2002 5:48:03 PM PDT by bonesmccoy
Below is a news release on a policy statement published in the October issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics (AAP) or Pediatrics electronic pages, the Internet extension of Pediatrics.
For Release: October 7, 2002, 12:01 am (ET)
CHICAGO - The American Academy of Pediatrics (AAP) in a new policy statement recommends ring vaccination for smallpox, also called surveillance and containment. Ring vaccination controls an outbreak by vaccinating and monitoring a ring of people around each infected individual. The idea is to form a buffer of immune people to prevent the spread of the disease in the event of an outbreak.
The AAP recommended the ring strategy rather than universal or voluntary immunization, citing potentially serious health risks from the vaccine weighed against the possibility, currently thought to be unlikely, that a smallpox attack could occur. The new policy stresses that a major reason not to initiate universal immunization in the absence of actual cases of smallpox - besides the limited availability of vaccine - is the risk of serious complications from immunizations.
According to Robert S. Baltimore, M.D., FAAP, member of the AAP Committee on Infectious Diseases (COID) and a lead author of the AAP policy, "The policy is flexible and could change if there is an actual outbreak of smallpox or if a safer vaccine becomes available." The AAP also is pushing for the vaccine to be tested on children before any immunizations are done.
The AAP understands that use of the ring vaccination strategy does not preclude either universal or voluntary vaccination if smallpox is introduced as a bioterrorist agent or if the likelihood of an attack is felt to be higher than currently believed. A critical part of building up the vaccine stockpile is to distribute vaccine around the country in such a way that it could be quickly - within 24 hours - distributed to every community.
One of the AAP's greatest concerns is that the general public is uninformed about the dangers of the vaccine, Dr. Baltimore said. "Many pediatricians are getting questions about it, and we want to arm them with information."
Common side effects from the smallpox vaccine include fever, weakness and lymph gland swelling or tenderness occurring about a week after immunization. Studies from the 1960s show approximately 1,200 people per 1 million immunized will suffer serious complications. Data from 1968 show at least 40 people per million immunized developed potentially life-threatening complications. Multiply those rates by 280 million Americans and "those reactions would end up being very high numbers," Dr. Baltimore said.
The AAP urges that the public should be educated about the possible serious adverse effects of smallpox immunization, especially for children, because surveillance studies demonstrate that they have a higher incidence of adverse effects.
I am a physician and deal with children's health care issues regularly. This statement is ill-conceived and should never have been published.
1. Ring Vaccination does not apply in a bioterror attack because the number of index cases can be in the hundreds to thousands. When the first cases are diagnosed, there will not be solo cases that are scattered. There will be dozens and dozens of cases with thousands of potentially infected contacts. These contacts must receive the needed vaccines within a few days. Yet, this county and the State of California has failed under Gray Davis' poor leadership to execute appropriate civil defense planning, imperiling millions of children in our state.
In comments published in the Arizona Daily Star public health authorities have already admitted existing plans are insufficient to protect the US citizenry. In the attachment following this brief statement, I will publish the exact text of the CDC's current recommendation.
(http://www.azstarnet.com/attack/20924nsmallpox.html) Quoting the article, "But Orenstein also pointed out that a smallpox outbreak could kill 300,000 people out of 1 million, making it an easy decision to take the vaccine."
2. AAP is a liberal organization who is supporting recommendations which will restrict civil liberties and force us into lockdowns and travel restrictions in the event of a biological attack. These restrictions will debilitate the US economy at the very time when our nation requires strength in a time of war.
Quoting the Arizona Daily Star's excellent story: "Last year, the CDC released a plan for vaccinating a "containment ring" of people exposed to a smallpox-infected patient. That plan instructs state and local authorities to be prepared to establish isolation facilities, suspend travel and put parts of cities into quarantine in the event of a smallpox attack."
In the event an attack occurs at a major sporting event or transportation center (like an airport, train station, or sea port), the initially ill will be spread over thousands of square miles.
3. AAP has timed the release of this press release to coincide with a major national security speech by the President of the United States. The failure of the AAP to put US national security first and their own political interests second reflects the liberal and socialist bias within the academy.
This policy statement is a product of politics, not scientific or clinical medical judgement.
It is outrageous that a major medical association would be reckless with US national security. In fact, the naivetee displayed by the physicians is profound. In the face of clear and unequivocal evidence that the Iraqi regime is pursuing biological weapons capable of delivery in the US, possible previous assault by Iraqi agents in the use of weaponized anthrax one year ago, and proven intent to utilize weapons of mass destruction; the AAP proposes to leave our children at risk of attack from Saddam's war machine.
It is obvious that minds like Benjamin Spock are laying a course that permits tyrannts to rule and threaten our children for the next generation.
I will not permit it!
This committee's decision can be best understood when one considers the fact that Bill Clinton and Janet Reno were invited to speak at the 1999 National Convention of the AAP in Washington DC only a few mere weeks after being impeached. AAP has consistently demonstrated bias in favor of Hillary Clinton's agenda, which is detrimental to our security and our lives.
We will not permit the AAP's existing warped prism to prevent truth from coming out. The AAP would be better served if they ceased this obstruction of vaccine distribution.
AAP claims that they are interested in the best interests of America's children.
Today, in the worst fashion, we see that AAP has it's own politics at it's heart, not the safety of America's children.
I am a conservative physician and would prefer to debate on the medical policiy issues. However, unfamiliar individuals need to be educated regarding the AAP's poor record of maintaining political independence.
Lest the reader believe that these opinions are only predicated on personal issues, let us discuss some facts based on CDC's own documents.
In reviewing the existing CDC Smallpox Recommendation there is a list of MANDATORY steps which MUST be taken prior to the attack.
NONE of these steps have been taken by the Davis Administration.
NONE were taken by the Clinton Administration.
THE AAP has not put resources in place to execute this plan.
This statement from the AAP is hypocritical political diatribe.
The American people and physicians across the United States are responsible. We are more than adult enough to handle the limited risks involved with this vaccine.
It is high time for AAP's bribed doctors, who control recommendations for the limitation of vaccine distribution to demonstrate some clinical judgement.
That clinical judgement is that voluntary immunization is an ethical, practical, and appropriate solution to the national security threat posed by the Iraqi biological weapons machine.
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Quoting CDC's own document on the existing smallpox vaccination strategy. http://www.bt.cdc.gov/agent/smallpox/response-plan/index.asp
Rationale for these Guidelines: Prevention of the spread of smallpox virus from patients to others is a critical part of the control strategy.
Smallpox patients usually transmit infection by expelled droplets to close contacts (those within 6 to 7 feet).
Although smallpox patients generally are infectious from the time of first development of rash, the earliest stages of the rash may be difficult to recognize.
However, preceding the development of rash, the patient will run a high fever for 2 to 3 days.
Isolation of a possible case from the time of onset of fever will provide a sufficient time to assure appropriate isolation measures are in place at the onset of their infectious period (rash). This isolation strategy in addition to vaccination of all of the close contacts to the case should sharply limit the spread of smallpox.
Suggested Pre-Event Activities Associated with Isolation/Quarantine Procedures
1. Assure local and/or state legal statures are in place to allow public health intervention and implementation of the isolation and quarantine measures outlined in this section.
2. Identify personnel responsible for local/state coordination of isolation and quarantine activities.
3. Identify appropriate facilities to be utilized for isolation and care of smallpox patients and febrile contacts as outlined and establish procedures for activating them.
4. Identify appropriate law enforcement entities to enforce isolation and quarantine orders.
5. Identify appropriate personnel (medical, maintenance, etc.) to maintain/staff facilities.
6. Establish procedures for monitoring and controlling access to facilities.
7. Establish procedures for appropriate disposal of medical waste when using a non-medical facility.
8. Establish laundry service arrangements (on-site if possible) and appropriate disposal of medical waste.
9. Arrange for food service support for facility occupants.
10. Establish procedures for monitoring health status of facility staff and plans for referral to appropriate care.
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Note: Very severe cases of smallpox (e.g. hemorrhagic and malignant) may generate aerosols spread the virus more widely than what is usually seen. Additional special measures (described below) may be needed in facilities where patients with hemorrhagic or severe (malignant) smallpox are seen.
One by J. Donald Millar, Free to Choose the Smallpox Vaccine. Millar is vice chair and a distinguished fellow of the Public Health Policy Advisory Board, and is a former head of the Smallpox Eradication Program at the Centers for Disease Control and Prevention.
Also, two others put out by the Cato Institute's Charles Pena:
The general public is uninformed about the dangers of ALL vaccines already. So what's his point?
The Bush administration itself is not sure what strategy is best, so why do you get off calling this organization's recommendation politically motivated. I think you have been drinking too much flouridated water or something. You certainly are paranoid.
Maybe the pediatricians strategy isnt right, however, I think they are right to be concerned about vacinnating every child against a pathogen that may never be released against them or any other child in this country. From what I understand, the current vacine has not been tested on children but that past evidence with older vacines has shown that children suffer more adverse effects than adults.
The alternate strategy to ring vacination is vacinating everyone either voluntarily or involuntarily. From what Ive read recently this could not be done currently even if every doctor and nurse were relieved of their current duties. The article I read recently suggested that it would take until 2004 for all citizens to be vacinated.
What is your concern about restricting travel? I sure as hell would shoot anyone who attempted to leave a contaminated area and thereby spread the disease further. You must be a libertarian who thinks he can do whatever he god damn wants to protect his ass even if it contaminates another 100,000 individuals. Fine example.
I didnt say 20,000 deaths, I said 20,000 deaths or severe reactions. Also 25 years ago, we vacinated only children, a small percentage of our entire population. I was vacinated back in the 50's and havent been vacinated again since then. Also the US population is much larger today than it was back in the 50-60's, therefore a percentage of that larger number leads to a larger total number people POTENTIALLY at risk for adverse effects.
My own thought but there are quite a few people who are more at risk from an immune standpoint today than in the 60's. More people with AIDS/HIV, allergies, chronic fatigue syndrome, etc. These people with immune problems are likely to be more at risk, either from direct immunization or close association with someone that was immunized.
I recall the number from several documents I read the other day when I did a search on Google. I believe it also matched up with a similar number from a Wall Street Journal article.
Yes. Ring vaccination worked well near the end of smallpox' existence in response to one or a handful of cases.
DA Henderson probably developed and carried out ring vaccination in the first place and it was very effective.
But the dynamics of a deliberate release of pathogen in to the population would be very different than that which was formerly met with ring vaccination.
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