March 17, 2003
Three decades ago, health officials in the United States were so confident
that smallpox had been erased as a concern that they stopped routine
vaccinations. While children and young adults throughout the country
have never been vaccinated, others received the vaccine over 30 years
"Smallpox...is now eradicated
after a successful worldwide vaccination program. The last case of
smallpox in the United States was in 1949. The last naturally occurring
case in the world was in Somalia in 1977. After the disease was eliminated
from the world, routine vaccination against smallpox among the general
public was stopped because it was no longer necessary for prevention."
Not having to worry about
smallpox (or the vaccine), many today know little about it.
"There are two clinical
forms of smallpox. Variola major is the severe and most common form
of smallpox, with a more extensive rash and higher fever. There are
four types of variola major smallpox: ordinary (the most frequent
type, accounting for 90% or more of cases); modified (mild and occurring
in previously vaccinated persons); flat; and hemorrhagic (both rare
and very severe). Historically, variola major has an overall fatality
rate of about 30%; however, flat and hemorrhagic smallpox usually
are fatal. Variola minor is a less common presentation of smallpox,
and a much less severe disease, with death rates historically of 1%
It is fairly safe to say
that no one wants a smallpox outbreak. So doctors and health officials
around the country are being asked to prepare to helpanyone who might
Dr. John R. Lumpkin, state public health director, today [January
24, 2003] announced Illinois has ordered 10,000 doses of smallpox
vaccine from the Centers for Disease Control and Prevention (CDC)
in preparation for the start of a voluntary program to protect public
health and hospital workers who would be called on to respond to an
outbreak of smallpox."
So, does this vaccine solve
"The smallpox vaccine
helps the body develop immunity to smallpox.... Currently, the United
States has a big enough stockpile of smallpox vaccine to vaccinate
everyone in the country who might need it in the event of an emergency.
Production of new vaccine is underway....the vaccine has been effective
in preventing smallpox infection in 95% of those vaccinated. In addition,
the vaccine was proven to prevent or substantially lessen infection
when given within a few days of exposure."
However, this vaccine is
not for everyone; and nothing is perfect, including this vaccine.
"Children younger than
12 months of age should not get the vaccine. Also, the Advisory Committee
on Immunization Practices (ACIP) advises against non-emergency use
of smallpox vaccine in children younger than 18 years of age. In addition,
those allergic to the vaccine or any of its components should not
receive the vaccine."
"Some people are at
greater risk for serious side effects from the smallpox vaccine. Individuals
who have any of the following conditions, or live with someone who
does, should NOT get the smallpox vaccine unless they have been exposed
to the smallpox virus..."
"As a result of these
precautions, the U-M [University of Michigan] researchers estimate
that 25 percent of the U.S. population would need to be excluded from
any smallpox vaccination campaign because they are high-risk for a
side effect or have close contact with someone who is at high-risk."
"Tuesday, February 25,
2003 WASHINGTON (Reuters) - Citing the need for its smallpox vaccination
program to include pregnant women, people with weakened immune systems
and other vulnerable groups, the US government on Tuesday announced
contracts with a Danish and a British company to make a safer vaccine....
'To protect ourselves from the remote, but extremely grave, threat
of a deliberate release of smallpox virus, we need a vaccine that
can be safely given to all Americans, including individuals with weakened
immune systems, children and pregnant women,' Health and Human Service
Secretary Tommy Thompson said in a statement."
So, what could go wrong?
Why is there such cause for concern?
"It is estimated that
for every one million people who are vaccinated, there would be:
* One or two deaths,
* Between 14 and 52 people would have a potentially life-threatening
* inflammation of the brain (encephalitis)
* progressive vaccinia, an ongoing infection that destroys skin tissue
* eczema vaccinatum, skin rashes caused by infections such as eczema
* About 1,000 people would have serious but not life-threatening reactions.
These include a toxic or allergic reaction at the inoculation site
and spread of the vaccinia virus to other parts of the body and to
"The smallpox vaccine
also causes milder reactions that usually go away without treatment:
* The arm receiving the vaccination may be sore and red where the
vaccine was given.
* The glands in the armpits may become large and sore.
* The vaccinated person may run a low fever.
* An estimated one-third of vaccinated workers would miss work from
one to a few days."
Smallpox is bad. While the
vaccine can be harmful to some, it can save the lives of many more.
Question of the Week:
Everyone has a different background and medical history. What information
should people have in order to make an educated decision about whether
or not getting the smallpox vaccine would be the best choice for them.
For more smallpox information, try:
Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.
I look forward to reading
what you have to say.
Health Community Coordinator
Access Excellence @ the National Health Museum