WASHINGTON – Maryland officials said they should have no problem meeting President Bush’s mid-February deadline for vaccinating up to 6,000 medical personnel who would be the first to respond to any outbreak of smallpox in the state.
Bush on Friday set the deadline for vaccinations of first-response medical teams around the nation, as well as military forces that might be called to respond to a bioterror attack.
The president did not call for the vaccination of all Americans at this time, but added that he himself planned to get the shot — which carries a minor risk of adverse reaction — since he was asking the civilian first responders to volunteer.
Maryland should be able to vaccinate the first responders within two to three days of receiving the smallpox vaccine, said Arlene H. Stephenson, acting secretary of the Department of Health and Mental Hygiene.
“Doing 6,000 people will be relatively easy for us because we have been working on this pre-event plan for months,” Stephenson said. “We have bee preparing, thinking that phase one would take place in mid-December, so we are about five weeks ahead of where we need to be.”
After months of discussion, the Bush administration settled on a three- step plan for smallpox vaccination that begins with first response teams, for which the Department of Health and Human Services has already recruited 439,000 volunteers.
Phase two will make the vaccine available to all health care and public safety workers. Phase three would be vaccination of the general public — although that is being not recommended at this time, said Tom Ridge, the president’s homeland security adviser.
Stephenson said the government is expected to release the smallpox vaccine Jan. 24. Once Maryland gets its dose, nine clinics around the state will begin vaccinating the first response teams. She said training for those clinic workers began Dec. 3.
State officials said more planning is needed for the next phases of the plan, but they do not expect problems.
Phase two in Maryland could involve about 180,000 health and emergency workers. But Stephenson expects about half of that number would defer or would be screened out because of other health conditions.
Every vaccine volunteer will be asked detailed questions about their medical histories and will be educated about the potential risks of the vaccine, she said.
The Department of Health and Human Services said normal reactions to the vaccine include a sore arm, swollen glands or low fever. In recent studies, one out of three people felt bad enough to alter their lifestyles, said Dr. Anthony Fauci, the director of National Institute of Allergy and Infectious Disease.
Fauci said about 1,000 people for every 1 million vaccinated for the first time experience serious, but not life-threatening, reactions and 14 to 52 people per 1 million have a potentially life-threatening reaction that requires immediate attention. One to two people per million die as a result of reactions to the vaccine.
Federal health officials said people should not be vaccinated if they have HIV, have eczema or other skin conditions, or have a weakened immune system because of cancer treatment or organ transplant. Women who are pregnant or breast-feeding and children younger than 18 months are also discouraged from being vaccinated.
The Bush administration said there is no reason to believe that smallpox presents an imminent threat, but the attacks of September and October 2001 have heightened concern that terrorists have access to the virus.
“Since the country was attacked 15 months ago, we are forced to prepare for attacks we hope will never come,” Bush said. “Although action is not imminent, it is prudent to prepare.”
The country has enough vaccine to inoculate the entire population and health workers have the capacity to do it, but experts do not believe mass vaccinations are necessary.
“It is important to have response teams ready,” Stephenson said. “It is important as a next step to have workers ready. But, I don’t think it is necessary for the general public to be vaccinated until there is an initial case.”