(Washington, DC) - District of Columbia Department of Health officials have developed a plan to vaccinate nearly 5,000 local public health and hospital personnel. The plan, which was released after the President gave final approval for the vaccination of first responders, lays the framework for the District to begin a voluntary vaccination program for local public health and hospital personnel in the event of a terrorist attack.
"With the help of the CDC and local health and hospital leaders, we have devised a strategy that will ultimately prepare and protect the residents of the District against the possibility of a smallpox attack by those who try to undermine and cripple our Country," said James A. Buford, Director of the Department of Health.
DOH officials submitted their plan for the first stage of smallpox vaccinations last week to the Center for Disease Control and Prevention. "In the plan submitted to the CDC, we addressed a wide range of details about the first phase of smallpox vaccinations," said Mr. Buford.
"The probability of an intentional release of the smallpox virus remains low; however, because the consequences of such an attack would be so devastating, we cannot afford to be caught ill prepared," added Mr. Buford.
In the plan, vaccination sites will be set-up throughout the District, allowing officials to vaccinate public health and hospital personnel who would likely be among the first exposed to a potential smallpox patient. "We are committed to improving our ability to protect the public," said Dr. Richardson Senior Deputy Director in the Department of Health. "It is vital that we continue to ensure that our first responders can safely respond to a smallpox outbreak."
As stated by the President, smallpox vaccines will not be recommended to the entire population. That could change should the risk become more imminent. According to the plan, people who are vaccinated are volunteers from the District’s smallpox response teams and hospital smallpox health care teams.
The plan allows for the vaccine to be administered in three phases and expected to begin in early January 2003 and to continue through late January or February. The first phase would be limited to hospital health care personnel and public health workers. It would include about 3,000 to 5,000 persons in the District. The second phase would be expanded to all emergency response personnel, which would be 50,000 to 100,000 firefighters, police, emergency medical personnel and other emergency workers in the District. The third phase would cover the general population, which would be about 600,000 residents and visitors to Washington. The workers in the first two phases would receive the vaccinations at their job sites or public health clinics. The general population would get them at various locations.
Participation in the vaccination program is voluntary for all workers. Those getting vaccinated will go through a screening process to eliminate persons with possible contraindications.
Smallpox is a disease caused by a virus (variola) and characteristically includes skin lesions that eventually scab over; at times it has been confused for chickenpox. In most cases, smallpox is spread by an ill person to others through infectious saliva droplets, but also can be spread by contaminated clothing or bed linen.
The disease, which historically killed 30% of its victims, was once one of the world’s most feared. At the same time, experts estimate that between 1 and 2 people out of every 1 million people (0.0002%) vaccinated may die as a result of life-threatening reactions to the vaccine. If used in biowarfare, smallpox virus could be dispersed in the air and potential victims in the area of the release would breathe in the virus, or infected persons could be sent into a crowded area to attempt to spread the disease to others.
Besides the complications, approximately 25 percent of the population cannot receive the vaccine because of health conditions. Those include pregnancy, skin disorders, organ transplantation, or treatment for HIV or cancer.
The last case of smallpox in United States was recorded in 1949. The last naturally acquired case of smallpox in the world occurred in 1977 in Somalia, Horn of Africa.