WASHINGTON – Some Maryland counties plan a second round of smallpox vaccinations, after a lull earlier this year that was brought on by adverse reactions to the shots and by dwindling concerns about bioterrorism.
Maryland got 6,000 doses of the vaccine but has so far inoculated only 744 people in what was supposed to be the first phase of a national effort to prepare healthcare workers and emergency crews for a possible terrorist attack using the smallpox virus.
Now, some counties hope to pick up where they left off.
“We aren’t recruiting people, or convincing people to do this,” said Ashley Conway of the Calvert County Health Department. “People have different reasons for wanting it, and different reasons for not wanting it.”
The vaccinations remain entirely voluntary, and Conway stressed that volunteers are told of the benefits and risks.
Calvert hopes to begin offering vaccinations next month to police officers and the county’s all-volunteer fire and rescue teams, adding to the 36 health professionals and hospital workers immunized earlier this year.
Montgomery County will begin training health care workers in the next couple of weeks on how to administer the vaccine, said Carol Jordan, director of communicable disease and epidemiology for the county Department of Health and Human Services.
Montgomery hopes to teach up to 500 health professionals how to give the shots, even if they don’t all agree to get vaccinated themselves. Should an outbreak occur, however, those workers would have to be vaccinated so that they could then administer the vaccine to others, Jordan said.
The county initially wanted to vaccinate 1,500 public health and hospital workers, but got fewer than 200 volunteers before the national effort ground to a halt.
The program slowed after several volunteers suffered adverse reactions, including a Maryland nurse who suffered a fatal heart attack five days after her vaccination. The Centers for Disease Control and Prevention has not concluded whether the vaccine was the direct cause of her death, but warned against vaccinating those who have been diagnosed with serious heart disease.
Others said world events reduced concern about smallpox.
“I think people felt really altruistic, they wanted to do something for the country while the war (in Iraq) was going on,” Jordan said. But several health officials said interest waned after the war failed to turn up stockpiles of smallpox.
“People have moved on to new threats,” said Cheryl Peterson, senior policy fellow at the American Nurses Association.
Smallpox was declared eradicated in 1980, but after the Sept. 11, 2001, terrorist attacks the Bush administration began acting in case bioterrorists brought the disease back. In December, the CDC called for 500,000 people to be vaccinated within two months. But nine months later, fewer than 40,000 have been vaccinated nationwide.
Most Maryland counties have not moved beyond the first phase established by the federal government — vaccinating local emergency response teams. Some counties have begun the second phase, which calls for vaccinating the larger public health community.
The CDC has not recommended implementing the third phase, vaccinating the general public.
Howard County has vaccinated 14 people in the health department, as well as the fire chief, a police detective and an ophthalmologist, said Lisa Heyward, spokeswoman for the county health department.
Washington County has vaccinated about 30 health care workers, half from the health department and half from the county hospital. Anne Arundel County has vaccinated 68, mostly from Anne Arundel Medical Center. Neither county plans to implement the next phase of vaccinations unless the state asks for it, county health officials said.
Montgomery County had set a high vaccination goal in part because of its proximity to the nation’s capital, Jordan said. It plans to begin another round of shots as early as December, though Jordan has not heard of new volunteers coming forward yet.
“I might just go into this without any goal in mind at all,” she said. “Then I won’t be disappointed.”