HOSPITALS DECLINE TO VACCINATE WORKERS (Washington, the State)

In the next few days, 4,000 doses of smallpox vaccine will travel from Atlanta to Washington state, and nestle into storage at a classified location.

On Tuesday, state health officials announced their order of the vaccine, adding Washington to a list of more than 40 states that have joined the federal government's smallpox immunization campaign.

While the state moves ahead, local hospitals fret. Throughout the South Sound, private health care providers are refusing to join the voluntary vaccination program, citing concerns about the safety of their patients and workers, and potential liability.

The list of nonparticipants includes eight private hospitals in Tacoma, Pierce County, Federal Way and Olympia. Some say they have decided not to decide. Others say they are waiting for more information.

"We really don't know what this vaccine will do in our population, and we're not going to know until we do it," said Marcia Patrick, infection control manager for MultiCare Health Systems, which includes Tacoma General Hospital, Mary Bridge Children's Hospital and Allenmore Hospital in Tacoma.

Leaders of the Franciscan Health System voice similar concerns. Franciscan operates St. Joseph Medical Center in Tacoma, St. Francis Hospital in Federal Way, and St. Clare Hospital in Lakewood.

Good Samaritan Hospital in Puyallup is not participating in the vaccination program. Nor will the Providence Health System, which operates Providence St. Peter Hospital in Olympia, and hospitals in Everett and Eastern Washington.

"It's a live virus and it's contagious," said Deborah Shawver, Providence spokeswoman. "We're concerned about the risk to our employees, and also to our patients."

The federal vaccination plan aims to create teams of "first responders" - public health and hospital workers - who could come in contact with smallpox cases in the event of an outbreak or a bioterrorist attack.

State officials downplayed the lack of participation among private hospitals. Donn Moyer, spokesman for the state Department of Health, said that even if hospitals do not participate immediately, they have been involved in planning a coordinated response to potential outbreaks.

"The big issue is we are hoping to be better prepared," Moyer said. "Regardless of how many hospitals are in or out, we will be better prepared."

The military is already giving shots to soldiers and sailors. Since Jan. 10, about 100 soldiers have been vaccinated at Madigan Army Medical Center, officials said Tuesday.

State and county health workers also will receive the vaccine when doses arrive from the federal Centers for Disease Control in Atlanta. At the Pierce County Health Department, 28 workers have volunteered for vaccination, said spokesman Vic Harris.

The shot, delivered with a two-pronged needle, leaves a scab that can shed "vaccinia," the live virus contained in the vaccine. The virus is not smallpox. It is a different pox-type virus that immunizes the recipient against smallpox.

Skin contact can spread the vaccinia. Of every 1 million people vaccinated, the Centers for Disease Control estimate 1,000 will get sick enough from the vaccine to require medical care, and one or two will die.

The vaccine also can't be given to people with impaired immune systems or with certain skin disorders, because those conditions make them more susceptible to serious side effects.

Because hospitals are more likely to have such people as patients, their leaders are more reluctant to join the vaccination program.

"Hospitals have populations of highly immune-compromised people," Shawver said. "There's a big difference between going back to work in an office and going back to work with a very sick cancer patient."

Hospitals and health departments also differ on how to treat people who have received the vaccine.

Pierce County health department workers will be allowed to return to work after being vaccinated, but they will be required to cover the site of their vaccination with a bandage to limit contact with the scab.

Conversely, most South Sound hospitals have decided that workers who have received the vaccine, such as military reservists, must stay home for 21 days - the expected length of time for the vaccination scab to heal. The potential loss of available workers associated with the vaccination program is another factor in the decision not to join the immunization program, officials say.

While South Sound health care leaders are taking a wait-and-see attitude, hospitals in Seattle have agreed to join the immunization program. Harborview Medical Center and Swedish Medical Center are preparing to immunize groups of workers who have volunteered.

"It was a very, very difficult decision," said Will Shelton, manager of epidemiology and employee health at Swedish. "But we believe we have an obligation to provide medical care to the community we serve."

The instructions on the vaccine, manufactured by a New Jersey-based pharmaceutical company, note that the scab from vaccination can take up to three weeks to heal. But federal health officials note that proper care and observation of the site will prevent exposure and infection.

At Swedish, Shelton said vaccinated workers will wear a special dressing and receive screenings each day to ensure that the site is covered and they are not experiencing side effects.

At the Pierce County Health Department, Harris suggested that hospitals will join the immunization program after they have a chance to see it in action.

"We're not telling the hospitals what they have to do," he said. "We are asking for them to participate. If they don't participate in the immediate future, I suspect they will participate down the road once X number of people have been vaccinated and terrible things don't happen and so there is that level of reassurance."

Maybe the rest of us who are well should get vaccinated? I really don't know where I stand on this.

The way they are pushing these vaccines it makes it seem as though a terrorist action is imminent. If they have such info they should just tell us.

I went to a lecture on this last week. Even if the vaccine were available to non-health care workers today, I wouldn't get it. There are tons of contraindications that were not as prevalent in the population 30 years ago as they are now.

However, if one confirmed case is found anywhere in the world, then I would get re-vaccinated as soon as possible. I was around when smallpox was "eradicated" and I fully expect to see it rear it's ugly head again in my lifetime.

My very conservative sister-in-law is a known reputible in the nursing field & this week we had a discussion on this. Bottom line, she will not get one at this time. That is how I have felt all along.

"We're not willing to be the canaries in the mine."

Drop the word "not" and the statement becomes accurate.

My husband is getting his in a week or so. We both had them when children so I don't feel there is a danger. He didnt have a reaction back then!

That's what I keep thinking.....it seems that the problem NOW is that people are "weaker?" than back in the 50's when I got mine? And, if that is so.....you would think us stronger ones should get the shots, cause it's going to be the weaker ones who will get it and spread it (watch the inner cities where the homeless and otherwise "weak" live.)

7 posted on 02/06/2003 3:25:03 PM PST by goodnesswins (Thank the Military for your freedom and security....and thank a Rich person for jobs.)

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