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Panel Rejects Smallpox Shots for All

Panel Rejects Smallpox Shots for All
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WebMD Health News
Reviewed by Gary D. Vogin, MD

June 20, 2002 -- After two days of weighing the pros and cons of giving the smallpox vaccine to all Americans, government officials have said it's just not worth the risk. But certain high-risk people should be vaccinated.

Since Sept. 11, the country has been on high alert, and the thought of a smallpox outbreak from bioterrorism has many running scared -- especially since there is no effective treatment for this virus.

Currently, only lab workers who handle the potentially deadly virus are given the vaccine. Some have suggested that widespread vaccination be reinstated in the U.S. However, critics of this proposal say the risk of severe side effects and death from the vaccine is too great.

Smallpox was declared eradicated more than 20 years ago and exists only in two places in the world -- labs in Atlanta and Russia. And the vaccine was largely responsible for making this happen.

The Advisory Committee on Immunization Practices, which met in Atlanta, is now recommending the vaccine only for certain high-risk groups. This would include doctors, nurses, infectious disease investigators, and law enforcement officials -- a team of people that would need to respond quickly at the first report of bioterrorism with the virus. In addition, states would be allowed to vaccinate hospital workers that would likely treat people with smallpox.

But the vaccine can help even if given after exposure to the virus. If the vaccine is given within four days of exposure to smallpox, it can lessen the severity of the illness or even prevent it, according to the CDC.

Most people infected with smallpox recover, but it's deadly in about 30% of cases, the CDC says.

The concern over widespread use of the vaccine is based on its severe side effects -- including severe rashes, brain swelling, and death. Also, if the vaccine were given to everyone in the U.S., about 300 to 500 people would die from the vaccine, the CDC estimates. That is about one or two deaths for each million doses of smallpox vaccine administered. The risk of side effects is greatest in children and people with immune system problems, such as those with AIDS.

The final decision of who should receive the smallpox vaccine rests with Health and Human Services Secretary Tommy Thompson.

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