Vaccination plan still meeting resistance

The enthusiastic response of states such as Connecticut notwithstanding, national leaders concede that the actual numbers of health care workers volunteering to be vaccinated is relatively small.

Centers for Disease Control and Prevention (CDC) director Julie Gerberding, MD, acknowledged as much during a Feb. 5 press briefing, noting that concerns expressed by health care groups regarding compensation in the federal voluntary smallpox program might be the cause of limited numbers of persons being vaccinated.

Gerberding said she was aware that compensation issues have health care providers concerned they may "fall through the cracks," and reported that although the CDC had shipped 204,600 doses of smallpox vaccine to 40 states and counties, a total of only 687 health care personnel had been vaccinated. (As of this writing, the total is slightly more than 1,000.) No adverse events have been reported, she said, but added that as the vaccinations increased, "we know we’re going to see side effects."

Meanwhile, the Washington, DC-based American Public Health Association (APHA) has recommended additional protections to ensure safe and effective implementation and renewed its call for a measured, deliberate approach.

"It is prudent for us to begin vaccinating the first 500,000 emergency health workers," said Georges Benjamin, MD, FACP, executive director. "This is an important step to further improve our public health preparedness efforts. However, civilian responders at the federal, state, and local level require and should be provided the same treatment as military participants in any smallpox vaccination program."

APHA identified several elements of the program that need to be addressed:

  • Adequate federal resources must be allocated to state and local health departments, hospitals, laboratories, and other organizations that are coordinating this program, and funds should not be diverted from other public health resources.
  • Liability protections must be granted for organizations and persons who participate in the vaccination program.
  • A national program must be established to compensate workers and others who suffer complications associated with the vaccine.

APHA also urged that access to treatment must be guaranteed for those who participate in the program; adequate education and training must be provided to all participants; medical screening should be provided prior to vaccination; ongoing surveillance for side effects and evaluation is required; individuals who participate or choose not to participate should not be discriminated against and their privacy rights ensured; the Food and Drug Administration should approve bifurcated needles for the smallpox vaccine; and sufficient doses of vaccinia immune globulin should be made readily available.