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December 2002 Smallpox news
Remember, 'news' contains a few interesting facts and lots of "party line" opinions.

Smallpox Vaccine Ingredients
Smallpox summit to be held
Israel's smallpox vaccination, gas masks ineffective

Smallpox Vaccine Test For Children Unlikely
Challenges lie in details of smallpox plan
"Smallpox vaccine Licensed"

Smallpox Vaccine May be Referenced in Bible Apocalypse
Spartanburg woman part of national smallpox study
Smallpox - 6 Articles in New Eng J. of Med

Gunmen Deputized to Secure Smallpox Vaccination Areas
Two IL hospitals won't give staff smallpox vaccine
Americans would refuse smallpox vaccination

Health Pros Balk At Smallpox Shots
Few Side Effects in Israeli Smallpox Vaccine Drive

Smallpox: Montana Responds
(tidbit) GA hospital doesn't give smallpox shot yet
Echo From an Earlier Smallpox War

Smallpox Shots: Make Them Mandatory
"60 Million May Die from Smallpox Vaccination"
Thompson Won't Get Smallpox Vaccine

Page 2 of Smallpox News, 24 more stories:

"Contrary to popular mythology, there's absolutely no evidence Iraq worked on smallpox"---Scott Ritter, Former UN Weapons Inspector (2002)

Smallpox Vaccine Ingredients

Note: received in email:
The Acambis vaccine cell lines contain (55 MILLION DOSES OF) ABORTED FETAL tissue. After the 55 MILLION doses are gone, the vaccine will contain vero cell lines. Vero Cells from the African green monkey open the door to tumors, cancers and HIV/Aids and other primate viruses etc.

The vaccine contains bovine material as well, which could be, as the experts claim, a THEORETICAL RISK for mad cow/nvCJD.

The aborted fetal tissue could also be a source of CJD,HIV, HCV etc etc.

Those who wish to research the contents of the vaccine can begin by checking out:

Smallpox summit to be held

Wed, 1 Jan 2003

CHEYENNE (AP) -- Five health care representatives from around the state plan to meet with state health officials over the next few days to finalize plans for smallpox vaccinations.

Vaccinations for medical workers, who would be the first to respond to a smallpox outbreak, are expected to begin in February.

The five representatives recently returned from a training seminar at the Centers for Disease Control and Prevention headquarters in Atlanta.

Among other things, the trainees learned how to use a bifurcated needle to pick up drops of the vaccine and poke it into a person's arm 15 times in a 5-millimeter area.

"What was amazing about the conference is that it makes smallpox a reality," said Katheryn McKee, a public health nurse for the Cheyenne-Laramie County Health Department. "This is something we are really preparing for."

State Epidemiologist Dr. Karl Musgrave said Wyoming initially will receive 2,600 doses of vaccine.

In January, the five representatives will disperse around the state to help prepare public health nurses for the first rounds of vaccination.

"There will be around 30 clinics across the state and they need to be divided up in the most efficient way possible," said Daniel Kessler, a risk communication specialist for the state Health Department.

McKee said CDC instructors stressed the importance of interviewing people before they are vaccinated to reduce the risk of complications.

"If someone has any history of eczema, since the virus isn't around right now, we're not going to go ahead with the vaccine and possibly harm them," he said. "Usually with immunizations, if you have questions you still go ahead. With smallpox it's different."

The vaccine is not recommended for people with eczema, atopic dermatitis, burns, herpes, chicken pox, weakened immune systems due to HIV or cancer treatments, allergy to the vaccine, or moderate to severe short-term illnesses.

Pregnant or nursing mothers and people under 18 should also not get the vaccine, according to state health officials.

Copyright © 2002 by the Casper Star-Tribune published by Lee Publications, Inc., a subsidiary of Lee Enterprises, Incorporated

Israel's smallpox vaccination, gas masks ineffective

Source: DispWhat=object&enDispWho=Article%5El1801&enZone=Security&enVersion=0&

Report: Israel's smallpox vaccination, gas masks ineffective
By Debbie Berman December 31, 2002

An internal Ministry of Health investigation of Israel's smallpox vaccine revealed serious negligence in its production, raising questions as to its effectiveness. A Ministry of Defense expert claimed two thirds of the gas masks distributed to the public would provide insufficient protection in case of a chemical or biological attack.

According to an exclusive report published today in Yediot Aharonot, the investigation conducted by Dr. Rachel Karpel, director of the Standards Institute in the Health Ministry, revealed sixty-eight areas in which the vaccination failed to meet international pharmaceutical standards. Karpel recommended that the existing supply of the vaccine be destroyed and that health officials should begin production of a new supply.

"If we were talking about a private manufacturer and normal circumstances, the Ministry of Health would demand stopping production and the immediate destruction of supplies," Karpel wrote. "It is clear that under these special circumstances we cannot immediately destroy the supply and be left completely helpless in an emergency," Karpel added, advocating a three-step process for phasing out the old vaccines.

According to the report, the ministry-produced vaccine was not inspected for additional viruses and germs, and it was stored in the same freezer as test tubes containing strains of cholera, plague and other diseases. The facilities used for the production of the vaccine were not sterile, the report said, and some of the bottles used were reportedly broken or caked with mud. The temperature of the vaccine's storage was reportedly not regulated and freezers malfunctioned on several occasions.

Israel's production of the vaccine is based on injecting the virus into a fertilized chicken egg and after a period of incubation, transferring the vaccine into test tubes, which are stored until inoculation. Most western countries today, including the United States, utilize cow specimens and not chickens egg to incubate the vaccination.

The internal Health Ministry report states that those infected during a smallpox outbreak in Yugoslavia in 1972 were inoculated with the chicken-based vaccine, which proved an ineffective form of protection. Following the outbreak, the local population there underwent a mass re- vaccination with the cow-based vaccine.

The Ministry of Health denied the Yediot Aharonot report regarding the shortcomings of the vaccine and urged the public not to panic. Health Ministry Dir.-Gen Dr. Boas Lev claimed Israel's vaccine is one of the most effective in the world.

"We take this very seriously," he said. "Following the Karpel report we stopped production and then all of our labs met all standards requirements. We have reached the conclusion that there is no need to worry about any problems. Our production process is better and cleaner than that of the Americans, and we have years of excellent experience in this process."

Critical report on gas masks
A Defense Ministry expert on protection against biological and chemical weapons said that only a third of the masks distributed to the Israeli public would serve as adequate protection in case of an attack, Ha'aretz reported today.

Despite a report criticizing the quality of the masks distributed to the public during the 1991 Gulf War, the Defense Ministry has continued to manufacture them without implementing changes or improvements to the units, said ministry official Esther Krasner.

In a report outlining their drawbacks, Krasner said the black rubber masks create "a range of problems that limit their use for long periods of time. The mask is conceptually based on sealing the face, which requires a high degree of customization and practice at putting them on. The mask causes psychological limitations because there is resistance to breathing, and tension caused by heat, pain and discomfort."

A defense establishment official said that one of the biggest problems with the mask is the fact that it comes in only two sizes. Therefore, the official said, the mask does not provide adequate protection to most of the population. Women with lower hairlines and narrow faces are more likely to experience leaks in their masks.

Krasner has criticized the ministry's refusal to adopt a hooded gas mask unit called the Sapphire, which would outperform the current black rubber masks, Ha'aretz reported. Krasner advocates making two fundamental changes to the black masks: adding a breathing mechanism, which would provide permanent airflow, and adding a hood to extend protection to the head and neck.

Responding to the reports, IDF Chief of Staff Lt.-Gen. Moshe Yaalon told the Knesset's Foreign Affairs and Defense Committee that the gas masks distributed to the public provided sufficient protection. Yaalon said the newer model gas masks did not meet security requirements.

Smallpox Vaccine Test For Children Unlikely dsfocus3067134dec31,0,3676845.story?coll=ny%2Dhealth%2Dheadlines

Vaccine Test For Children Unlikely
Debate clouds chance for smallpox trial


December 31, 2002

By the time smallpox vaccinations are offered to the public in 2004, researchers will have gathered reams of information on dosage for virtually every age, with the likely exception of children.

Key researchers close to a major pediatric test of the vaccine told Newsday last week they doubt the trial will proceed, the result of negative public response to the prospects of a trial.

The issue of smallpox-vaccine testing in children has inspired debate and sidelined clinical testing, a controversy underscoring a broader issue: Many drug therapies ultimately administered to children are never tested in them.

Though the Bush administration two weeks ago vowed support for a new measure requiring drug companies to routinely test medications in children, officials did not say whether the pediatric trial of the smallpox vaccine should go forward. If the vaccine is not tested and licensed for pediatric use, children whose parents want them vaccinated in 2004 would be barred from receiving the shots.

Medical historians say use of the smallpox vaccine in children has a long and storied past.

Dr. J. Michael Lane, a retired immunization director at the U.S. Centers for Disease Control and Prevention, said the standard dose was established by consensus among physicians a half century ago, not by way of clinical testing.

Even though the vaccine was administered for more than a century before smallpox was declared eradicated in 1980, the potential for side effects was commonly accepted as a risk of preventing a dangerous disease, experts say.

"Until the 1970s and even into the '80s, the smallpox vaccine dose was driven by our desire to have maximum 'take' rates," Lane said, referring to evidence of immunity. "When there was smallpox in the world, we did everything possible to ensure good take rates."

There was a lot of questioning about how much vaccine should be put on the needle used to administer the vaccination, Lane said. "It was almost like asking how many angels could dance on the head of a pin.

"Now the game is different. It would be nice to get good takes, but it would be even better to do that with a minimalist dose. That has never been worked out. There's no good pediatric data. What I'm saying here is there's no data - period - for this population."

Federal health officials solicited public opinion in October on the issue of testing diluted doses in children, in response to opposition from anti-vaccination group leaders as well as the public. The clinical trial, which was to have begun before year's end, is on hold.

Patricia El-Hinnawy of the federal Office of Human Research Protection, which solicited public reaction, said the decision now rests with Health and Human Services Secretary Tommy Thompson.

"We have no idea when he will decide," El-Hinnawy said.

Given the opposition - during the comment period, more than 300 responses opposed to such testing were submitted - Lane said doctors face a difficult situation.

"You can't license a vaccine for kids until you test it in kids," he said. "Despite the fact that many people in the medical community want to test it, it's difficult to move beyond those who say it's unethical. But I think the FDA [Food and Drug Administration] is correct in saying we can't license it without testing it first."

Groups such as the National Vaccine Information Center, based in Vienna, Va., contend that, with only a theoretical threat of smallpox, the risks of the live-virus vaccine outweigh its benefits.

Smallpox vaccine at standard dosage is estimated to cause up to 2.7 deaths, as well as 15 adverse reactions, in 1 million people who receive it. Reactions range from flulike symptoms to encephalitis. Doctors do not know - but some suspect - that adverse outcomes would be lessened with a weakened vaccine.

Results of a major clinical trial of 680 adults between the ages of 18 and 32, reported in March, showed that diluted vaccine - up to one-tenth the standard strength - worked as well as the so-called standard dose in producing immunity.

The trial is instructive, scientists say, because it demonstrates that a weaker dose works in an age group never before vaccinated against smallpox. The last case of the disease in the United States occurred in 1949; routine vaccinations ceased in 1972. A new trial, headed by medical investigators in New York, is enrolling 1,000 volunteers across the country to test the vaccine in adults between the ages of 32 and 75.

Experts on bioterrorism in the Bush administration have said an attack using the virus as a weapon is probably remote, but they nevertheless believe terrorist groups possess the virus.

Despite a freeze on the pediatric vaccine trial, administration officials want to establish keener dosages for all other medications given to children. Thompson last week said the administration would support the new measure, a new Pediatric Rule, calling for testing medication dosage levels in children.

Even if the smallpox vaccine is never tested in children, experts say a new Pediatric Rule would eliminate guesswork when it comes to establishing doses for other medications administered to children. The FDA had made a rule in 1998 requiring drug companies to test medications in children, but it was shot down in October by a federal judge in Washington, who said the agency was exceeding its authority.

"We have strongly defended the Pediatric Rule in court," said FDA Commissioner Dr. Mark B. McClellan, "because public health will be best served by enabling the FDA to require testing of drugs for pediatric use. But continued litigation is likely to take years, and its outcome is uncertain."

"This is a very complex issue," Lane said. "I am passionately pro-vaccines. I was director of a national immunization program, and part of my job was aggressively promoting vaccination.

"I can understand people who say it's unethical to administer smallpox vaccine to children. But it's also an awkward situation for people who want to run the vaccine trials" to determine the best dose.

Challenges lie in details of smallpox plan


Challenges lie in details of smallpox plan
Health professionals are being asked to step up to be vaccinated, but physicians and other experts worry about putting immune-compromised patients at risk.

By Victoria Stagg Elliott, AMNews staff. Jan. 6, 2003. [Received 30 DEC 2002] Additional information

Military personnel and embassy staff in high-risk areas will get it. President George W. Bush will, too. But his family members won't. And emergency physicians, other doctors and health care workers will be offered it as a precaution in the event they are part of volunteer response teams in the aftermath of an attack.

It is the smallpox vaccine, and the specifics of who should get it and when are part of President Bush's smallpox response plan unveiled in December 2002.

But the details of how the approach will be implemented are raising concerns within the physician community over persistent questions of logistics, safety and liability.

For now, though, the president's marching orders are clear: "Our government has no information that a smallpox attack is imminent," he said. "Yet it is prudent to prepare for the possibility that terrorists ... who kill indiscriminately would use diseases as a weapon."

During the past year, public health agencies have been planning for this type of attack, stockpiling enough vaccine to immunize every person in the United States, drawing up response models and training several thousand clinicians to administer the vaccine to those most likely to be on the front lines. The public is expected to be offered the vaccine next year. For many public health officials, the vaccination question is the most unusual health issue they've ever faced.

The vaccination plan raises questions about logistics, safety and liability.

"This is not a very easy decision," said Jonathan B. Weisbuch, MD, representing the American Assn. of Public Health Physicians at the AMA Interim Meeting in New Orleans in December 2002. "We're being asked to do harm to people in [light] of unknown risk out there."

The mixed reaction from the health care community to the president's plan reflects this uneasiness.

Several medical groups, including the Infectious Disease Society of America, the American Public Health Assn. and the AMA, endorsed the approach. But Service Employees International, the country's largest union of nurses and other hospital employees, and the American Nurses Assn. did not -- warning that the plan put their members and patients at risk. Serious issues remain

Even those who are most supportive of the plan have reservations. Their focus is on issues of liability, the risks posed to patients and themselves, and how screening procedures could determine who among the most likely first responders should receive or not receive the vaccine.

The Homeland Security Act passed in 2002 does give physicians and other health care workers who administer the vaccine liability protection, but several organizations have expressed concern that this shield may not go far enough. For example, the doctor or nurse who gives the injection will be protected, but what about the patients who receive it?

A vaccinated person will be a potential danger to immune-compromised people for a few weeks. Will that individual be at fault if the virus is inadvertently transmitted to another?

50% of the public would turn to their physicians for information in a smallpox crisis.

"The Dept. of Homeland Security bill was signed by the president, and that addresses some of the issues of liability, but there are questions that continue to be asked by physicians and patients for which we still await the answers," said Scott D. Deitchman, MD, MPH, a member of the AMA Council on Scientific Affairs, in New Orleans.

But although physicians are worried about being liable for any adverse reactions, there is also great concern about ensuring compensation for those harmed by the vaccine. The SEIU and ANA both issued statements saying that such funding might be needed, not just for the people who may be killed or disabled, but also for those who may be sickened for a few days and lose work and wages.

Both groups also were concerned that the vaccinations be truly voluntary, without fear of discrimination or reprisal for declining the offer.

As for public health officials, they are struggling to create an effective screening process and to develop a hierarchy to figure out who should be vaccinated in the first phase. Those who are full-time hospital staff members should be easy to track. But what about temporary and part-time workers, especially in a large facility?

And if all of those on the list are vaccinated at once, who will care for patients? Should the effort include staggered timing to ensure that doctors, nurses and aides are not all exposed to the vaccine at once, to ensure adequate staffing can be maintained?

Meanwhile, there is evidence that covering the injection site with a dressing and long sleeves may prevent transmission. Frequent hand-washing also will help. But nothing is 100% effective.

58% of the public fears a smallpox attack.

"It reduces the risk significantly but not to zero," said Michael Williams, MD, an American Academy of Neurology delegate to the Interim Meeting. "There are many who are seriously considering that we ought to advocate for administrative leave for health care workers because we don't know what the risk to our patients would be, even if that risk is low."

President Bush did not comment on the steps to be taken in case of an outbreak, but the CDC's response plan includes guidelines for organizing "ring vaccinations," a strategy for immunizing all contacts that effectively eradicated smallpox.

This approach has been endorsed by several medical associations, including the AMA. Few public health experts, however, believe that it would be workable.

"As much as I, from a public health purist perspective, would like to use the post-event ring strategy -- and it will be important initially -- ultimately ring vaccination will fail in this country if imposed, simply for political reasons," said Donald E. Williamson, MD, Alabama state health officer, speaking for the Assn. of State and Territorial Health Officials at the AMA meeting. "It simply won't happen."

Back to top.

Worry erupting

A recent poll reflects a growing concern among the public about the threat of a smallpox terrorist attack. Findings are based on a telephone survey of 1,002 adults conducted in October 2002 and compared with results from a similar survey taken in May 2002. Of those questioned:

* 65% are willing to be vaccinated against smallpox, compared with 59% last May.
* 58% said they are worried about a possible smallpox attack, compared with 43% in the earlier survey.
* 50% said they would put their highest level of trust in their doctor when seeking information during a smallpox crisis.
* 12% said they were not at all worried about an attack, down from 25% in May.

Source: Robert Wood Johnson Foundation

CDC smallpox site (

HHS smallpox site (

AMA Council on Scientific Affairs bioterrorism site

"Smallpox vaccine Licensed"

Dec 02.

"Smallpox vaccine Licensed"
The stockpiled Dryvax smallpox vaccine now available in a new format--a 100-dose kit that allows dilution of the vaccine--has been licensed by the FDA.

Each kit, manufactured by Wyeth Laboratories, Inc., includes one vial of lyophilized smallpox vaccine (dried, calf lymph type), one prefilled diluent syringe, one transfer needle, and one box of bifurcated needles. The kit is ready to go if and when the government decides to vaccinate the general public against smallpox.

The kit's label states that nonemergency use of the vaccine is not recommended for the following segments of the general population: infants younger than 12 months; pregnant women; people of any age with eczema or other exfoliative skin conditions; people of any age who are allergic to any element of the vaccine; people of any age on high doses of corticosteroids or immunosuppressive drugs; and people of any age with immune system deficiencies.
Family Pracitice News, Dec. 1, 2002

Smallpox Vaccine May be Referenced in Bible Apocalypse

Date: 25 Dec 2002

Tetrahedron Publishing Group
Health Science Communications for People Around the World
206 North 4th Avenue, Suite 147
Sandpoint, ID 83864
208-265-2575; FAX: 208-265-2775

Release: No. DITA-105
Date Mailed: Dec. 24, 2002
For Immediate Release
Contact: Elaine Zacky 208/265-2575; 800/336-9266

Smallpox Vaccine May be Referenced in Bible Apocalypse

Sandpoint, ID
The Bush administration s embattled smallpox vaccination program looks even more devilish than medical doctors fear. The Bible apparently warns of polluted vials used in the End Times to transmit a foul-smelling pox-like plague upon the earth.

The smallpox vaccine produces an oozing infectious sore that authorities warn may infect others with the deadly contagion. Its scab then turns to a scar leaving a "mark of the beast" that appears to be described in The Book of Revelation 16:1-2 and 13:18. With the advancement of nanotechnology, many people fear the smallpox vaccine may also carry programmable biochips.

This final book of the Bible is traditionally neglected by those who prefer to preach the good news of spiritual salvation, versus the prophesy of apocalyptic destruction, according to Dr. Leonard Horowitz. The emerging diseases expert with a postdoctoral degree from Harvard University in public health believes these verses may regard the smallpox vaccine in particular.

According to Dr. Horowitz, "the Great Creator grows tired of people's misplaced faith and trust in the last days before the final judgment. MDs, or 'medical deities,' are politically elevated to positions of authority over life and death through a 'beast system' heavily engaged in a pharmaceutical cult." In this regard, Revelation refers to drug companies and medical physicians as satanic "sorcerers" that cast "magic spells" through healing potions and deceive even the world's wealthiest people. Their misplaced loyalties are reflected in their industry logo - an image depicting the staff of life with a snake twirled about it.

God finally dispatches help to put an end to this grave deception. In Rev. 16:1-2 the first of seven apocalyptic angels is instructed to pour out a deadly vial of liquid on the people. Suddenly, "there fell a noisome [foul smelling] and grievous sore [only] upon the men which had the mark of the beast and upon them which worshipped his image."

"Given recent disclosures of the high risks of disease and death from smallpox vaccinations, this message delivers food for thought," Dr. Horowitz says. Especially in a secular world wherein people have yet to learn the wisdom behind the Bible s warning, "Come out of her my people, lest ye be infected by her plagues."

Amazingly, in his most recent of thirteen books, prophetically titled and released three months before the 9/11 attacks on America, Death in the Air: Globalism, Terrorism and Toxic Warfare (1-888-508-4787), Dr. Horowitz decrypted an early British secret society's code that uses the multiples of six (6). It deciphers the word "VACCINATION" into "666."

"Try using this alphanumeric mystery school math for yourself," he encourages. "A=6, B=12, C=18 . . . and so on to Z. Using this decoding method, V=132, A=6, C=18, C=18, I=54, N=84, A=6, T=120, I=54, O=90 and N=84. That totals precisely 666, the number Revelation 13:18 also warns is associated with the mark of the beast."

Even more bizarre, the name "Santa Claus," Dr. Horowitz explains, deciphers to "666" too, but not likely by accident. History shows this name also derives from Britannia. "Look up the phrase 'Lord of misrule' in Webster's Dictionary," challenges the doctor minister. "It's defined as 'a master of Christmas who revels in England especially in the 15th and 16th century.'"

One might be inclined to scoff at these details, but the primary smallpox vaccine maker for America is a British company called Acambis (acquired by Aventis following 9-11). Moreover, Dr. Horowitz has been incredibly accurate with his predictions detailed over the Internet at Merry "X-mass" everyone.

- end -

Note to journalists: For additional interviews on this topic contact Dr. Leonard Horowitz at 208-265-2575 or

Spartanburg woman part of national smallpox study

(Greenville-AP) De. 23, 2002 - A 49-year-old Spartanburg dental assistant has become part of a nationwide study looking to prevent serious reactions from smallpox vaccine.

Debbie Summey was accepted into the trial last week. She will be vaccinated against smallpox after Christmas. After a few weeks, technicians will collect her plasma, which will be rich in smallpox antibodies, and ship it to a company in Canada. There, her plasma will be combined with other donors to create a treatment used on people who have severe reactions to the smallpox vaccine.

More than a million military personnel and health care workers will be vaccinated beginning next month. Some scientists estimate 15 out of every million people vaccinated will have serious complications, and two out of every million will die.

Posted 12:21pm by Deirdre Edwards

Smallpox - 6 Articles in New Eng J. of Med

20 December 2002



The articles listed below were published today at to help to inform the current national debate about smallpox vaccination. The articles will appear in the January 30, 2003, issue of the Journal.

Perspective: Smallpox Vaccination -- The Call to Arms
T.L. Schraeder and E.W. Campion

Special Article: A Model for a Smallpox-Vaccination Policy
S.A. Bozzette and Others

Special Article: The Public and the Smallpox Threat
R.J. Blendon and Others

Current Concepts: How Contagious Is Vaccinia?
K.A. Sepkowitz

Sounding Board: A Different View of Smallpox and Vaccination
T. Mack

Letter to the Editor: A Smallpox False Alarm
J.A. Hanrahan, M. Jakubowycz, and B.R. Davis

Gunmen Deputized to Secure Smallpox Vaccination Areas

Date: Fri, 20 Dec 2002

Two IL hospitals won't give staff smallpox vaccine,1,4535669.story

2 state hospitals won't give staff smallpox vaccine

By Jeremy Manier
Tribune staff reporter
Published December 19, 2002

Two Illinois hospitals have joined a growing group of medical centers nationwide that are opting out of a federal plan to vaccinate emergency workers against smallpox, reflecting concerns that the known risks of the vaccine may outweigh the uncertain threat of a terrorist attack with the virus.

Carle Foundation Hospital in Champaign and Decatur Memorial Hospital in Decatur notified the Illinois Department of Public Health in the last week that their workers will not be vaccinated, public health officials said Wednesday.

At least two other hospitals in Atlanta and Virginia also have said they will not take part in the voluntary plan, citing the small but real risk that vaccinated workers could suffer serious side effects or accidentally transmit the vaccine's virus--which is different from smallpox--to patients.

Such opposition could pose an obstacle to President Bush's plan, announced last Friday, to vaccinate up to 11 million people against smallpox, including a first round of 500,000 hospital and health agency workers. Bush has stressed that participation is voluntary, and Illinois health officials said they will not try to persuade hospitals to take part.

Dr. James Leonard, chief executive officer of Carle Foundation Hospital, said he struggled for more than a week over whether any of the 2,400 workers at his hospital would get inoculations.

Leonard said that after consulting with experts around the country, he was struck by the consensus that while the risk of a smallpox attack is unknown, the vaccine's risks are clear: Up to 52 people out of every million vaccinated could experience life-threatening side effects, with one to three dying. The vaccinia virus used for immunizations also can pose a risk to people with weakened immune systems, including patients with AIDS or cancer.

"I thought to myself, `What are we missing?'" Leonard said. "I came to the conclusion that we were not missing anything--[the plan] had taken on a life of its own, and I just couldn't justify the risk to the folks that work here and to our organization."

Dr. Gary Noskin, chief of infection control at Northwestern Memorial Hospital in Chicago, said the hospital has not yet decided whether to take part in the smallpox plan. He said some experts fear that news of adverse reactions to smallpox vaccines could sour the public on shots for diseases with a more immediate threat, such as measles.

Another concern is legal liability for vaccine side effects. Although the recently passed Homeland Security Act would protect municipal health agencies, experts say it's unclear whether hospitals could be held liable for complications that their employees or patients experience.

"I suspect that will be tested in the courts," Noskin said.

Illinois officials asked 152 hospitals outside Chicago to submit their plans for smallpox vaccination by Dec. 13. About 75 percent of hospitals had returned their plans as of Wednesday, public health spokesman Tom Schafer said. The Carle Foundation Hospital and Decatur Memorial are the only two that have said they will not take part.

Chicago public health officials said their preparations will take another few weeks, but so far no city hospitals have told authorities that they will not participate.

Schafer said health officials will not try to persuade hospitals to take part. In the event of an actual smallpox attack, he said even hospitals that do not participate could be protected. The smallpox vaccine can provide protection up to 72 hours after someone has been exposed to the virus, and federal plans call for the ability to vaccinate every person in the U.S. within 10 days in case of an outbreak.

"In the event of a localized outbreak, the vaccine would be offered in those areas first," Schafer said.

As for the current vaccination plan, Schafer said, "We've stressed that it's strictly a voluntary program."

Copyright 2002, Chicago Tribune

Americans would refuse smallpox vaccination

Posted on Thu, Dec. 19, 2002 Study: Americans would refuse smallpox vaccination if doctors rejected it
Knight Ridder Newspapers

PHILADELPHIA - (KRT) - Americans may criticize, disobey and sue their physicians, but when it comes to getting the smallpox vaccine, Americans will likely imitate them.

A new survey by Harvard University researchers indicates that 80 percent of Americans would refuse precautionary vaccination if they heard that their own and many other physicians were rejecting it.

Most Americans - 67 percent - also would decline to be inoculated if they heard that "some people" died from it.

The findings have implications for the Bush administration's two-stage plan for voluntary vaccination of more than 10 million health, emergency and police workers as a precaution against a smallpox attack.

Already, some physicians are declining to join the first stage, which involves vaccinating 500,000 health workers and "first responders" beginning next month. The doctors argue that the vaccine's risks are real and quantifiable, while smallpox, a disease that was eradicated 22 years ago, remains a theoretical threat.

Several major medical centers, notably Grady Memorial Hospital in Atlanta and Virginia Commonwealth University's hospital in Richmond, have officially opted out of the vaccination program. Some others, including Children's Hospital of Philadelphia, are considering it.

"The decision comes down to this: Which is the greater risk right now, vaccination or smallpox?" said Paul Offit, head of CHOP's Vaccine Education Center. "We are leaning toward saying there is more real risk in vaccination."

In October, Offit was the only member of the Centers for Disease Control and Prevention's vaccine advisory committee to oppose vaccination of 500,000 workers. Instead, he advocated inoculating a team of 15,000 who could respond to a smallpox outbreak.

Many physicians are worried that the vaccine might accidentally infect hospital patients, with deadly consequences. That's because the vaccine is a primitive type made from a live cowpox virus that can be spread, just like any virus.

Physicians also have expressed concern about Bush's promise to make the vaccine available to any adult American who "insists," because the public does not understand the risks and benefits of inoculation.

Indeed, the Harvard survey - published Thursday as part of a special online release by the New England Journal of Medicine - suggests Americans are largely clueless about smallpox, despite an avalanche of news coverage. (The nationally representative sample of 1,006 people was interviewed from Oct. 8 to Dec. 8.)

Almost a third of respondents said they believed smallpox had struck in the United States in the past five years, and two-thirds said they believed there had been outbreaks elsewhere in the world. (Actually, the disease was eradicated in the United States in 1949 and in the world in 1977.)

More than three-quarters believed smallpox can be treated to prevent death or disability. (Actually, the infection is untreatable, kills a third of its victims and disfigures or blinds most of the rest.)

Only 42 percent knew that the vaccine, if given within two or three days of exposure to smallpox, can prevent infection, and even fewer believed there would be enough vaccine in an emergency. (Actually, the government has stockpiles and plans to vaccinate the whole country if bioterrorists attack anywhere.)

The level of ignorance "is surprising to me because there has been a lot of coverage," said survey author Robert J. Blendon, a professor at Harvard's School of Public Health. "They just aren't taking away the basics."

That's probably because 66 percent had been ignoring or barely following smallpox news - a statistic that suggests healthcare workers will not bone up on the vaccine until they are required to.

Oddly, more than half of respondents were willing to be vaccinated - unless, that is, their doctors refused or they heard some people died from it - yet the vaccine was perceived as far more dangerous than it actually is. A quarter thought it would likely kill them, while 41 percent thought they would likely suffer serious side effects.

Such effects are actually rare, based on studies from the 1960s. For every million people vaccinated, the immunization causes about one death and about 52 life-threatening fevers, infections or brain-swelling.

CDC officials say they are working feverishly to overcome the knowledge gap. The agency has developed a website (, CD-ROMs, videos and a public information hotline (888-246-2675). Friday, the CDC will conduct a satellite broadcast from noon to 1:00 p.m. EST to help educate healthcare workers; it will be rebroadcast on Jan. 9 at 1:00 p.m. EST.

The CDC is not surprised by resistance to the vaccination program, director Julie Gerberding said. The agency "fully expected" that some hospitals would refuse to participate. Even so, she said, all 50 states have submitted plans that, if successful, will vaccinate 440,000 workers at 3,600 medical facilities.

Health Pros Balk At Smallpox Shots

December 19, 2002

(AP) Many doctors and nurses nationwide are wary of President Bush's suggestion that they be vaccinated against smallpox, and some hospitals have rejected the proposal as too risky for their employees.

"There are concerns about the efficacy of the vaccine and the risk for taking the vaccine," said Jim Lott, spokesman for the Hospital Association of Southern California. The group represents 190 private and public hospitals.

"On rare occasions, we hear about people who say they want to step up and serve their country," he said. "But we're hearing more the other way," with employees raising questions.

Seeking to be prepared for attacks with biological weapons, the Bush administration has ordered a half-million U.S. soldiers in high-risk regions to get smallpox vaccinations, and proposed voluntary vaccinations for millions of health care workers.

Jim Bentley, a senior vice president of the American Hospital Association, said most hospitals seem willing to participate, others are deliberating, and a few have indicated they do not want their staff vaccinated.

Among the reluctant facilities are Grady Memorial Hospital in Atlanta and Virginia Commonwealth University's health center in Richmond, Va.

Dr. Richard Wenzel, chairman of Virginia Commonwealth's infectious disease department, said the hospital would support the program if a single case of smallpox were reported or if federal authorities warned of imminent danger of an outbreak.

"Meanwhile, it is difficult to support the decision to vaccinate hospital personnel when there has been no case of smallpox seen for 30 years," Wenzel said Wednesday.

There is a "very large probability" that vaccinating hospital workers would result in transmission of the disease to people whose resistance had been lowered by HIV infection and other conditions, Wenzel said.

"When we weigh the risks and benefits, we choose to come down on the conservative side," he said.

However, Bush's proposal has been embraced elsewhere.

"We do have a plan to give the smallpox vaccinations," said Kristin Foley at Seattle's Harborview Medical Center. "This is not an issue for us."

Dr. J.D. Miller of Appalachian Regional Health Care, which operates nine hospitals in Kentucky and West Virginia, said many employees strongly supported the program and were anxious to get vaccinations.

Hospitals in Iowa are discussing the program, said Kevin Teale of the state Department of Public Health, "but we haven't been given a flat-out no by anyone."

The American Medical Association has endorsed the concept of voluntary vaccinations for health care workers, but says it will monitor the program for possible complications.

The American Nurses Association has been even more cautious.

"We want people to be able to make an informed decision," the association's president, Barbara Blakeney, said last week. "I do not believe we have the answers we need to make that informed decision."

Blakeney said nurses, like other hospital workers, were worried about questions of liability and whether they would be compensated for treatment of possible side-effects caused by vaccinations.

"It is our duty to protect, as much as possible, those persons who would step forward to protect us all," Blakeney said.

Under the federal plan, civilian vaccinations will proceed in two phases. They will begin in a few weeks for about 450,000 people - including emergency room staff - most likely to encounter a highly contagious smallpox patient.

Later, vaccinations will be offered to about 10 million additional emergency responders, including police officers, firefighters and a wide range of health care workers. Health officials predict about half of this group would agree to vaccinations.

Connecticut's 32 hospitals are coordinating their response to Phase One of the program, asking about 150 people at each hospital if they are willing to be vaccinated. Those employees will go through an education program before making a final decision.

In Minneapolis, the Hennepin County Medical Center is recruiting volunteers to be vaccinated and then serve on a special smallpox response unit. The center hopes for 200 volunteers, but could operate the unit with as few as 40, said emergency preparedness director Mark Lappe.

Initial interest is high, Lappe said. "But what many other agencies across the country have experienced is once people look more closely, there's a significant drop-off."

Few Side Effects in Israeli Smallpox Vaccine Drive

Posted on Thu, Dec. 19, 2002

Few Side Effects in Israeli Smallpox Vaccine Drive Reuters

JERUSALEM - Israel's smallpox vaccination of 15,000 emergency workers in preparation for a possible U.S.-led war on Iraq caused few side effects, a Health Ministry spokesman said on Thursday.

Four people were hospitalized as a result of the vaccination drive, said spokesman Ido Hadari.

These included the child of one worker and the spouse of another, who had come into contact with their family member's vaccine scar, causing blisters and a mild fever. The other two were treated for minor side effects.

Smallpox vaccination can carry severe side effects and even cause death in very rare cases.

Hadari said Israel was sharing its results with the United States which vaccinated 100 military medics on Wednesday in the first wave of a program to immunize millions of troops and emergency workers who could be called to respond to any smallpox attack.

Washington launched the drive amid concern some terror organizations could have developed smallpox into biological weapons.

The virus kills around 30 percent of its victims.

Israel and the United States also fear Baghdad may have developed smallpox as a weapon. Israel is preparing for possible Iraqi missile attacks should the United States launch an offensive against Baghdad.

Babies born in Israel were inoculated with the smallpox vaccine up until 1980, and all Israeli military conscripts were vaccinated until 1996.

"You can expect that one case out of a million that gets the vaccination might die. In a population that has been vaccinated in the past, we can say there will be only one death for every two to four million," Hadari said.

Israel has stockpiled enough doses of smallpox to vaccinate its entire population of six million. Hadari declined to say when the rest of the population might be vaccinated.

Iraq fired 39 Scud missiles at Israel in retaliation for U.S.-led air attacks during the 1991 Gulf War.

The missiles were armed with conventional warheads but some Israelis fear Saddam Hussein may arm Scuds with chemical or biological warheads if he believes the U.S. is on the verge of ousting him.


Wednesday, December 18, 2002

By Jon Rappoport

DECEMBER 19. Before our eyes, the mass smallpox-vaccine plan is going into the toilet. NBC is reporting, get THIS: "Health officials strongly discourage this [getting the vaccine], and said once people became aware of the risks, they expected few to press for the vaccine."


More from NBC: "'The federal government is not recommending vaccination.of the general public,' said Health and Human Services Secretary Tommy Thompson. 'There may, however, be members of the public who insist on being vaccinated.'"


Dr. Anthony Fauci, who leads the smallpox vaccine program for the US National Institutes of Health, said [this is MSNBC's paraphrase of Fauci: "While the vaccine will be offered to adults on a voluntary basis, it will not be available for children except in the event of a smallpox [biowar] attack." Then Fauci remarked on the record: "Ethical and safety concerns bar children from clinical trials being conducted now, meaning the vaccine cannot be licensed for them. If Mom comes up to one of the local and state health officials and says, 'I want vaccine for my 5-year-old,' currently there doesn't appear to be a mechanism for them to get it."


And then we have this, which I thought was a hacker's trick of inserting an early April Fool's story at AP: "Health and Human Services Secretary Tommy Thompson said Sunday he does not plan to be inoculated with the smallpox vaccine and recommends that other Cabinet members not request the inoculation either."



If I'm hallucinating and these wire stories and NBC and CNN reports are all part of a plot of to personally derange me, I'll take the heat.




Do you think hundreds of people putting out the truth about this vaccine on the Internet had any effect on the sudden and amazing turnaround by the government?




Smallpox: Montana Responds

Montana Will Vaccinate Core Group for Smallpox

HELENA - Up to 3,000 public health professionals and select health care workers in Montana will be offered the smallpox vaccine starting next month in compliance with President Bush's national plan announced Friday.

The state plan calls for offering vaccine to a small team of state Department of Public Health and Human Services employees and to similar teams of health care workers throughout the state, such as physicians and nurses. All vaccinations are voluntary.

"In anticipation of the President's announcement, Montana and every other state have established procedures to comply with whatever is requested by the White House," said Terry Krantz, who is overseeing Montana's smallpox vaccine policy planning for DPHHS. "We are sharing information and requests with tribal and county health departments, hospitals, clinics and other emergency personnel, and we are gathering their input and listening to their needs."

To help maintain a timely and accurate flow of information to the public regarding smallpox, Krantz and members of his staff on Thursday invited the Montana media to ask any and all questions they have related to smallpox.

Detailed information about the virus and Montana's planning efforts are also available through the Centers for Disease Control and Prevention at and via the DPHHS web site at

"We want the public to be as informed as possible about the smallpox virus and the vaccine," Krantz said. "We recognize the value of making good information available to the public to reduce anxiety, and will continue to do so."

The White House plan calls for three phases of vaccinations. The first, tentatively set to begin in January calls for vaccinating the public health and health care workers.

Phase two involves vaccinating first responders, such as fire fighters, emergency medical technicians, law enforcement and other health care workers.

Phase three involves offering the vaccine to the general public. However, immunization of the general public at this time is not recommended.

GA hospital doesn't give smallpox shot yet

Date: Tue, 17 Dec 2002

A tidbit with thanks to: Sheri Nakken
Grady Mamorial Hospital is at 80 Butler Street SE, Atlanta, GA 30303
CDC is at 1600 Clifton Road, Atlanta GA 30333
Mapquest shows a distance of 5.03 miles between the two addresses, and estimates the driving time to 11 minutes

CDC told them something they aren't telling the rest of the world?
Or they know the CDC too well and aren't going to listen to them?

Grady's workers won't be given smallpox shot yet
Risk outweighs threat, hospital says

Atlanta Journal-Constitution Staff Writer
Grady Memorial Hospital has decided not to vaccinate its workers against smallpox, backing away from a state and nationwide campaign to protect health care workers before any possible bioterrorist attack.

Echo From an Earlier Smallpox War

Date: Mon, 16 Dec 2002
Before you read this news story, first read these few short paragraphs from The Drug Story by Morris A. Bealie
Bringing the subject down almost to date the rawest publicity stunt pulled by public relations firms for the biologicals manufacturing business was in New York City in February and March of 1947.
On February 25 Eugene LeBar, a Mexico City importer took a bus to New York City. On March 10th he died in one of the city hospitals. The diagnosis was "hemorrhagic bronchitis." Somewhere between that date and April 10th the Rockefeller public relations firm, recently assigned to the American Medical Association because the upward spiral of drug trust profits wasn't spiraling upward fast enough, had a brilliant idea.
Senor LeBar, they reasoned, during his long trip had been in the same atmosphere with thousands of people from El Paso to New York. Why not drum up a smallpox scare all over the United States and make ten million more dollars filling the nation's blood stream with cow pus and horse filth.
With New York's publicity-loving, Mayor, William O'Dwyer, as the spearhead, this is exactly what they did. The bronchitis diagnosis was changed to one of smallpox 30 days after Senor LeBar's demise. Mayor O'Dwyer ordered everyone in New York vaccinated, although he had no more power to do this than Mahatma Gandhi had.

A Distant, Troubling Echo From an Earlier Smallpox War

The word went out: everyone in New York should get a smallpox vaccination. "It was just public knowledge," my mother recalled 55 years later. "It was in the newspapers. On the radio."

It was early April 1947. I was 6 months old. A month earlier, a man returning from Mexico had fallen ill and checked into the city's Willard Parker Hospital, where he died on March 10. By the time a smallpox diagnosis was confirmed, two other people were showing symptoms.

On April 5, Dr. Israel Weinstein, the director of public health, announced an outbreak. A few days later, after a second death, he urged all New Yorkers to be vaccinated, regardless of age and previous vaccinations.

Last week, the call for smallpox vaccinations was again sounded, though this program is more limited - for now. In its first phases, a million military personnel and civilian health care workers will be vaccinated. In 2004 the vaccine is expected to be available to the public, on a voluntary basis.

Back in 1947, the response - also voluntary - was overwhelming. Within two weeks of the discovery of a potential epidemic, five million people were vaccinated.

The emergency mentality from the recent war mobilization helped. People waited for hours in the rain. Private doctors, public and parochial schools, company and union clinics and 3,000 volunteers pitched in. Former air raid wardens kept the throngs calm. Shots were given in the 84 police precinct station houses. Newspapers ran pictures of city officials getting shots. "Among city residents vaccinated yesterday were 25 children, from babies of 2 months to adolescents of 13 years," at one center, The New York Times reported.

My father, a Navy officer, had worked with Filipino civilians on Leyte after the 1944 invasion; he and a lot of other recently returned veterans had seen the terrible disfigurement of smallpox up close. Mom took me from our Riverside Drive apartment to the pediatrician's office for the vaccination.

About 10 days later, I grew restless and irritable. A fever kept rising. I was admitted to the hospital, had convulsions and went into a coma. The diagnosis was vaccinial encephalitis, a brain inflammation linked to the vaccine. The doctors told my mother they didn't know whether I would live, or whether there would be neurological damage.

After days in intensive care, the fever broke, and I went home. I grew up with chronic tics, similar to the muscle spasms of convulsions, that I have to fight to this day. Their connection to my encephalitis cannot be proved, but, according to the Centers for Disease Control and Prevention, they are consistent with the neurological effects of the disease.

Smallpox vaccine, made from vaccinia, a cousin to smallpox, is among the most dangerous of vaccines. I was lucky. A 3-year-old girl in New Jersey died of vaccinial encephalitis in April 1947 after her shot. I graduated from Harvard and eventually became an editor at The Times.

By virtually any measure, the 1947 crash vaccination program was a huge success. Twelve cases of smallpox were reported, with two deaths. (A 1901-02 outbreak caused 1,959 cases and 410 deaths.) But the same spirit that allowed near-universal vaccinations did not extend to thorough reporting of side effects.

In a November 1947 article in The American Journal of Public Health, Dr. Weinstein minimized the problem. He noted 46 probable cases of encephalitis in New York City during the vaccination campaign, adding that many were probably unrelated to the vaccine, but he did not try to estimate the number of cases of vaccinial encephalitis, explaining that a diagnosis could be made "with certainty" only by microscopic examination of the brain tissue.

A University of Michigan medical team reported in March in the journal Effective Clinical Practice that the data presented from the 1947 campaign in New York were of limited value in judging the adverse effects of mass smallpox vaccinations "because of differences in disease classification and inconsistency in case-finding efforts." We will never know the collateral damage from the 1947 program.

The study noted that smallpox had a 30 percent death rate, but that a mass vaccination of 179 million people ages 1 to 65 could be expected to cause about 4,600 serious side effects and 285 deaths, even if it excluded those at risk for problems, like pregnant women and people with immune deficiencies. That is not a lot of illnesses compared with unchecked smallpox, but we don't face unchecked smallpox. We face the unknown. Smallpox vaccine fights smallpox; the truth fights terror.

If we are going to go to war against smallpox, and there is any perception that side effect statistics are being ignored or suppressed, it will serve as a powerful recruiting poster for those who fear vaccines. The victims of vaccination's collateral damage need to be counted.

Smallpox Shots: Make Them Mandatory

On Sun, 15 Dec 2002
Smallpox Shots: Make Them Mandatory
When it comes to epidemic diseases, you don't get to decide. The state decides
By CHARLES KRAUTHAMMER,9171,1101021223-400014,00.html

Monday, Dec. 23, 2002
The eradication of smallpox was one of humanity's great success stories. After thousands of years of suffering at the hands of the virus, the human race gathered all its wit and cunning and conquered the scourge, eradicating it forever. Well, forever lasted less than 25 years. It does not bode well for the future of our species that it took but a blink of the eye for one of history's worst killers to make a comeback - not on its own, mind you, but brought back by humans to kill again.

During the age of innocence - the '90s, during which it seemed history had ended - the big debate was whether the two remaining known stocks of smallpox in the world, one in Russia and the other in the U.S., should be destroyed. It seemed like a wonderful idea, except that no one could be absolutely sure that some smallpox stores had not fallen into other hands. In fact, we now think Iraq is working on weaponizing smallpox, and perhaps North Korea and others too.

The danger is greater now than ever - first, and ironically, because of our very success in eradicating it in the past. People today have almost no experience with, and therefore no immunity to, the virus. We are nearly as virgin a population as the Native Americans who were wiped out by the various deadly pathogens brought over by Europeans. Not content with that potential for mass murder, however, today's bad guys are reportedly trying to genetically manipulate the virus to make it even deadlier and more resistant to treatment. Who knows what monstrosities the monsters are brewing in their secret laboratories.

What to do? We have enough vaccine on hand, some diluted but still effective, to vaccinate everyone in the U.S., with more full-strength versions to come. President Bush has just announced that his Administration will take the concentric-circle approach: mandatory inoculations for certain soldiers, voluntary inoculations for medical and emergency workers, and then inoculations available to, but discouraged for, everybody else.

It sounds good, but it is not quite right. If smallpox were a threat just to individuals, then it could be left up to individuals to decide whether or not they want to protect themselves. When it comes to epidemic diseases, however, we don't leave it up to individuals to decide. The state decides.

Forget about smallpox. This happens every day with childhood diseases. No child can go to school unless he's been immunized. Parents have no choice. Think of it: we force parents to inject healthy children with organisms - some living, some dead - that in a small number of cases will cripple or kill the child. It is an extraordinary violation of the privacy and bodily integrity of the little citizen. Yet it is routine. Why? Because what is at stake is the vulnerability of the entire society to catastrophic epidemic. In that case, individuals must submit.

Which is why smallpox vaccines were mandatory when we were kids. It wasn't left up to you to decide if you wanted it. You might be ready to risk your life by forgoing the vaccine, but society would not let you - not because it was saving you from yourself but because it had to save others from you. The problem wasn't you getting smallpox; the problem was you giving smallpox to others if you got it. Society cannot tolerate that. We forced vaccination even though we knew it would maim and kill a small but certain number of those subjected to it.

Today the case for mandatory vaccination is even stronger. This is war. We need to respond as in war. The threat is not just against individuals, but against the nation. Smallpox kills a third of its victims. If this epidemic were to take hold, it could devastate America as a functioning society. And the government's highest calling is to protect society - a calling even higher than protecting individuals.

That is why conscription in wartime is justified. We violate the freedom of individuals by drafting them into combat, risking their lives - suspending, in effect, their right to life and liberty, to say nothing of the pursuit of happiness - in the name of the nation.

Vaccination is the conscription of civilians in the war against bioterrorism. I personally would choose not to receive the smallpox vaccine. I would not have my family injected. I prefer the odds of getting the disease vs. the odds of inflicting injury or death by vaccination on my perfectly healthy child.

Nonetheless, it should not be my decision. When what is at stake is the survival of the country, personal and family calculation must yield to national interest. And a population fully protected from smallpox is a supreme national interest.

If it is determined that the enemy really has smallpox and might use it, we should vaccinate everyone. We haven't been called upon to do very much for the country since Sept. 11. We can and should do this.

From the Dec. 23, 2002 issue of TIME magazine

"60 Million May Die from Smallpox Vaccination"

For 60 million, the cure may kill

Fri Dec 13, 7:18 AM ET

Steve Sternberg USA TODAY

Mother's intuition may have saved Melissa Schweitzer's life.

A sickly child, Melissa was plagued with chronic infections, so her mom decided to let her skip her smallpox vaccination.

Doctors didn't figure out until Melissa was 11 that she lacked a natural supply of three infection-fighting antibodies, which put her at risk of a massive infection -- from the live virus, called vaccinia, used to make smallpox vaccine.

''Mothers' intuition,'' says Schweitzer, now 34, who gets monthly antibody infusions to protect her from ordinary infections. ''There's something to be said for it.''

Schweitzer, of Annapolis, Md. is one of about 60 million people in the USA with conditions that leave them essentially defenseless against vaccinia.

They include people with HIV (news - web sites)/AIDS (news - web sites) or other immune deficiencies, people who have had organ transplants, cancer patients undergoing chemotherapy and people with eczema and certain other skin diseases.

Health authorities also advise against vaccinating women who are pregnant or who might become pregnant because no one knows how live vaccinia might affect fetuses.

Vaccinia is a much weaker version of its relatives, smallpox and cowpox. In most cases, it is readily conquered by a healthy person's immune system. But even in healthy people, vaccinia can have life-threatening side-affects.

Research done in the 1960s found that 12 people per million develop an infection of the brain called encephalitis. One or two per million die. The research suggests that widespread vaccinations would cause about 4,600 serious side effects and 285 deaths.

Anyone whose condition hasn't been diagnosed, like young Melissa, faces the greatest risks. That population includes about 300,000 people in the USA with undiagnosed HIV. Some may become infected simply by coming in contact with someone who has just been vaccinated with smallpox vaccine.

The Bush vaccination plan, to be released today, represents a relatively small-scale beginning to mass vaccinations. But even a limited program could unleash vaccinia among some people who are defenseless against it.

Because the risk of a smallpox attack is unknown, health authorities can't accurately balance the risks of vaccination against the likelihood of a smallpox outbreak. Until a case appears, the risk of the vaccine will always be greater than the risk of getting smallpox. And any vaccine-related illnesses could have a far-reaching impact on public acceptance of vaccines.

''Experts are worried,'' says Tara O'Toole, of the Center for Civilian Biodefense at Johns Hopkins University's Bloomberg School of Public Health, ''that a general vaccination program will inevitably cause some lethal side effects . . . (that will) demolish the public's faith in vaccination and in following the government's bioterrorism recommendations.''

Once smallpox is released, the scenario changes dramatically because the disease is deadly, and it spreads rapidly. Smallpox kills about 30% of its victims, each of whom may pass the virus to as many as six people.

Everyone will be vaccinated if a case is detected. People who have had contact with a known or suspected case and who have not been vaccinated would be isolated to keep them from passing on the disease, says Marcella Layton, director of communicable diseases for the New York City Department of Health.

''Our medical advisers favor isolation over vaccination,'' says Jonathan Goldsmith, medical director of the Immune Deficiency Foundation, an advocacy group. ''We think that's your best choice. Keep kids out of school and parents out of work for a few weeks.''

O'Toole says she believes people will demand vaccination, ''especially when they see the first cases of smallpox on TV.''

Doctors can treat severe vaccine reactions with potent anti-vaccinia antibodies drawn from the blood of people who have gotten the vaccine. But that preparation, called vaccinia immune globulin, or VIG, is in short supply. Only 600 doses exist, but the government has ordered about 30,000 more.

An additional option is the drug Cidofivir, which is now licensed to treat retina infections in people with HIV and AIDS.

Doctors say Cidofivir could be used alone or along with VIG, making smallpox the latest in a small group of viruses that are beginning to yield to treatment.

Thompson Won't Get Smallpox Vaccine

Thompson Won't Get Smallpox Vaccine Health and Human Services Secretary Tommy Thompson Says He Won't Be Inoculated Against Smallpox

The Associated Press

Health and Human Services Secretary Tommy Thompson said Sunday he does not plan to be inoculated with the smallpox vaccine and recommends that other Cabinet members not request the inoculation either.

"I do not believe it is necessary or should be taking place," he said.

President Bush said Friday he will take the vaccine along with U.S. military forces but was not recommending the risky inoculation for most Americans. The inoculation will be free for those who want it, Thompson said over the weekend.

"The president is doing it because he is the commander in chief, and he believes that if he is ordering his troops ... to get this vaccination, he should do it as well," Thompson told CNN's "Late Edition."

"He also is recommending that elected officials be considered just like the general public, and I have also made the same kind of recommendation to the governors and to health offices who are not going to be in the first line."

Vaccinations for a few dozen military personnel began Friday. By late January states are expected to begin inoculating health care response teams and others who would respond to a smallpox attack.

The government will make the vaccine available to the general public beginning in late spring or early summer, although it is not recommended for most people.

The vaccine carries rare but serious side effects. One or two out of every 1 million patients will be killed by the vaccine, and 15 will face life-threatening complications.

Smallpox was eradicated in the 1970s and, while experts fear that terrorists or hostile nations could unleash it in an act of bioterror, Bush says no immediate threat exists.

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