CATONSVILLE – This is what the fight against smallpox looks like.
At a dimly lit auditorium, health workers repeatedly plunged tiny, fork- shaped, needles into a fleshy pad before calmly passing the perforated mass to the person standing next to them.
Their expressions alternated between intense concentration and giddiness as the roughly 90 volunteers practiced the lost art of administering smallpox vaccinations.
Thursday’s training session was the fourth, and likely last, training session offered by the state, as it gears up to vaccinate the healthcare workers who would be on the front lines of any bioterror attack.
The 300 to 400 health care workers who have been trained by the state so far will not only be administering the vaccine — they will be the first vaccinated with the live virus that can cause serious reactions and, in rare cases, even death.
“I’m amazed by people’s willingness to take this responsibility,” said Julie Casani, the director of the state’s Community Health Administration.
But volunteers like Debbie Saylor shrug off fears of a bad reaction to the vaccination.
Saylor, a registered nurse and the bioterrorism emergency response coordinator for Carroll County, said she does not have any of the conditions, such as emphysema, pregnancy or a compromised immune system, that could lead to a bad reaction.
“I feel like I will be safe because I’m protected,” she said. “I’m in a position where I can use my knowledge to investigate smallpox cases and I don’t have any of the contra-indicators.”
She is in the minority in her county. Saylor said that about 80 percent of the people in the Carroll County Health Department could not be vaccinated because they or one of their family members has a contra-indicator.
The shortage of candidates is not a problem now, Saylor said, but could become a problem in the future if the state expands the vaccination program.
The vaccination of health workers is the first phase in a national program to prepare the country to respond to a bioterror attack. The program, which cannot begin until President Bush signs the Homeland Security Bill on Friday, includes a second phase under which emergency workers would be vaccinated. It could ultimately include a third phase under which shots would be offered to the general public.
The last routine smallpox vaccination was given in 1972, when the disease was declared eradicated. But talk of a new round of vaccinations has drawn criticism because of their inherent risk.
But for Dr. William Woodward, the risk of vaccination is small compared to the devastation of the disease. The Carroll County physician said the government needs to provide more information about the possibility of a smallpox attack to encourage people to get vaccinated.
“This whole issue would be resolved if we knew the likelihood or the risk of it (smallpox) being released,” Woodward said.
Thursday’s program discussed the logistical problems volunteers might face with vaccinations, like transportation and storage of the vaccine, and included training films and practice sessions with the needles.
Smallpox vaccine is given with a two-pronged needle that is jabbed into the skin about 15 times over an area the size of the tip of a pinkie. The vaccine is then dripped over the punctured area and covered with three layers of protection to keep the virus from spreading.
The process usually takes about 15 minutes, Casani said, but explaining the risks of the vaccination and the proper care of the live virus can cause sessions stretch up to an hour.
Joey Scalitta, an epidemiologist and training coordinator for the Department of Health and Mental Hygiene, said Thursday’s volunteers included the doctors and nurses who would be actually administering vaccine, and others who would be concerned mainly with the management side of the program.
Casani said that once Maryland receives the vaccine, it will probably take them about nine weeks to vaccinate the 6,000 first responders in the state.
The shots will be given out on a staggered basis so that the flu-like symptoms that the vaccine can create will not cause a large number of health professionals to miss work at the same time, she said.