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Published: Tuesday, 12/10/2002

Smallpox vaccine plans are expanded


Smallpox vaccination plans submitted by local health officials to the Ohio Department of Health call for 3,500 health-care workers at 31 northwest Ohio hospitals to be vaccinated as a precaution against a possible terrorist attack.

The total, which includes 1,250 health-care workers in Lucas County, is an increase from earlier estimates that called for one fourth that many needing vaccinations. The latest plan, which covers 18 northwest Ohio counties, calls for 100 vaccinations at each hospital, except for 250 at Toledo Hospital and 250 at St. Vincent Mercy Medical Center, which are the region's two major trauma-care hospitals.

State officials estimate up to 13,000 health-care workers statewide will be vaccinated. Michigan authorities estimate 5,000 to 7,000 health-care workers statewide will be vaccinated.

Smallpox is fatal in up to 30 percent of those infected. The last case of the virus worldwide occurred in 1977, and the United States stopped vaccinating in 1972. But security experts fear terrorists could get their hands on the virus; so authorities have been formulating two basic plans to defend against the disease.

In “post-event” plans all states have already submitted to federal authorities, each state has worked out how it intends to vaccinate its entire population in 10 days or less. This plan would be activated if a case of smallpox shows up.

Yesterday, all states were to have submitted “pre-event” smallpox vaccination plans to the Centers for Disease Control and Prevention in Atlanta. Vaccinating physicians, nurses, and other workers is part of the “pre-event” strategy.

In this strategy, 500,000 health-care workers nationwide would be vaccinated against smallpox before an actual case shows up. The thinking is health-care workers would have to care for any victims of a terrorist attack that involves smallpox. The second phase of this pre-event strategy involves vaccinating 10 million first responders nationwide, including police, paramedics, and firefighters. All vaccinations in this “pre-event” strategy are voluntary.

Federal officials have insisted no decision has been made on who, or whether, to vaccinate. However, local health officials said they have been told the decision is pretty much made.

“The expectation is it's a go. It's just a mater of when,” said Larry Vasko, deputy health commissioner for Toledo and Lucas County.

Under the local plan, Mr. Vasko said vaccine will be shipped to three sites in northwest Ohio and be given first to teams at city and/or county health departments. In Lucas County's case, about 50 health department people would be vaccinated. These teams will then travel to each hospital and vaccinate the health-care workers. All health-care workers needing vaccinations would receive them within 30 days, he said.

Dr. David Grossman, health commissioner for Toledo and Lucas County, said he has some concerns about the vaccine's side effects, which are higher than those associated with most other vaccines. Up to one or two people per million could die from the vaccine, and up to 50 in a million could have life-threatening problems, said Dr. Grossman, who would be one of those vaccinated.

State and local authorities have so far refused to turn over copies of state or local vaccination plans, citing an exemption under Ohio public records law adopted in May and covering “security and infrastructure records.” That exemption includes records of “specific and unique response plans” that are “intended to prevent or mitigate acts of terrorism” and which would affect “emergency response personnel.”

The Blade has sought the plans to keep the public informed about what the state and local response would be in the event of a smallpox attack and/or outbreak.

Bret Atkins, a spokesman for the Ohio Department of Health, said the state isn't releasing copies of the vaccination plans because the plans contain sensitive information.

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