WASHINGTON – State health officials said it is too soon to tell if a Maryland nurse’s death after she received her smallpox shot will affect a vaccination program that they said had been gaining steam.
The death of the unidentified woman, along with six other reports of heart problems after vaccination, led the Centers for Disease Control and Prevention this week to recommend that anyone with heart problems not get vaccinated.
The ban is a precaution, since there is no known direct link between the vaccination and the death of the nurse, who apparently suffered a heart attack Sunday.
Maryland health officials said that there had been an increase in the number of health care workers volunteering for the smallpox shots, after a somewhat slow start, since few serious reactions had been reported.
“I think participation is going to increase in our April and May clinics,” said Katherine Farrell, the deputy health officer for the Anne Arundel County Health Department. “I don’t think we’re going to get up to the full number of Doses, but it’s kind of hard to tell. We’re certainly in a better place than we were in January.”
The pool of eligible workers was already small before this week’s ban on people with heart conditions. Health workers can be prohibited if they have conditions such as eczema, a compromised immune system or a pregnant spouse, for example.
The federal plan calls for 500,000 health care workers to be vaccinated in phase one as a guard against a possible terrorist attack with the potentially deadly virus. Phase two will be the vaccination of first responders like police officers, firefighters and emergency medical technicians.
Phase three, if necessary, will be vaccination of the general public. Mass smallpox vaccinations in the United States ended in 1972.
Maryland health departments and hospitals had vaccinated 414 people by Wednesday, state officials said. Nationally, 21,698 people had been vaccinated as of March 14, with about 19 of them reporting severe to moderate side effects, according to the CDC.
Maryland health officials said one woman developed a severe rash after her shot, but the most common complications so far have been itching and swelling around the vaccination site.
But critics say the lack of serious reactions does not mean state and federal officials should ignore their concerns about inadequate compensation for lost time, program funding and comprehensive training.
“People are not going to be forthcoming until they know that these things are available to them,” said Catherine O’Neal, director of nursing for the emergency department at Mercy Hospital in Baltimore. “They (the federal government) should have had this is place three months ago, it should have been thought out.”
O’Neal, who has been vaccinated, said a federal proposal only provides about $260,000 for death or permanent disability and ignores short-term absences because of complications. Maryland’s worker’s compensation program covers some missed time, but ignores costs of hospitalization, she said.
But health officials said other factors are more to blame for the pace of vaccinations.
“Some of the slowness goes beyond people simply being hesitant about getting vaccinated, there are other issues that people just needed to chew on a bit,” said Rod MacRae, a Washington County Health Department spokesman.
He and others said that people are not likely to volunteer for the shots while questions about the likelihood of an attack remain.
Dr. Christa-Marie Singleton also blamed sensational stories in the media that discuss the probability of death and severe reactions from vaccination. The stories often ignore the fact that these statistics are calculated from the general population, which has not been screened as heavily as health care workers are being screened.
“When people see the negative reports, that causes reluctance,” said Singleton, the director of public health emergency preparedness for the Baltimore County Health Department. “People don’t realize the screening process that takes place.”
Farrell said Anne Arundel County has inoculated about 50 of the 218 hospital and health department workers scheduled for vaccination, and she expects to finish by May. MacRae said about 27 people have been vaccinated in Washington County and that the county has the doses for about 100 people.