U.S. Soldier Dies Several Days After Smallpox Shot
By Paul Simao
ATLANTA (Reuters) - A U.S. soldier who was recently vaccinated
against smallpox has died from a heart attack, the third death among
those participating in the federal campaign to inoculate hundreds of
thousands of military personnel and health care workers.
A Department of Defense (news - web sites) official said on Friday
that the 55-year-old National Guardsman had died in an unidentified
U.S. military hospital on March 26, six days after receiving his
smallpox vaccination.
Two female health care workers who were recently vaccinated against
smallpox have died in the past week of heart attacks.
Col. John Grabenstein, scientific director for the Pentagon (news -
web sites)'s smallpox vaccination program, said the deceased soldier
was being treated for high cholesterol and was a smoker at the time
he received his smallpox jab.
"We are categorizing this event at the moment as unlikely to be due
to smallpox vaccination," Grabenstein said during a conference call
with other smallpox vaccination experts and government immunization
experts.
"We are not finished with our evaluation," said Grabenstein, who
noted that more than 350,000 soldiers had received smallpox shots
since late last year when President Bush (news - web sites)
authorized the vaccination program.
The soldier's death, however, occurred amid growing scrutiny of the
campaign. There have been more than a dozen other cases of heart-
related complications in U.S. soldiers and health care workers who
received the vaccine.
The possibility of a link between the deaths and the vaccine prompted
the U.S. Centers for Disease Control and Prevention (news - web
sites) to recommend this week that people with heart disease not be
vaccinated until further notice.
Earlier this month, top U.S. health officials had said that reports
of side-effects linked to the current smallpox program were
overblown. Smallpox kills about 30 percent of its victims and scars
the remainder for life. It was eradicated in 1979.
The United States stopped routine smallpox vaccinations in 1972, but
decided to resume them for select groups last year as fears grew that
the virus could be used as a weapon by radical groups or countries
like Iraq (news - web sites).
When administered in the past the vaccine killed between one to two
out of every million people inoculated and caused others to suffer
brain damage. But it has never before been linked to heart problems.
TOP of page
Second worker dies of heart attack after smallpox vaccination
LAURA MECKLER, Associated Press writer Thursday, March 27, 2003
(03-27) 15:11 PST WASHINGTON (AP) --
A second health care worker has died of a heart attack after receiving the
smallpox vaccine, and officials are investigating whether vaccinations are
to blame for cardiac problems seen in 17 people who have been inoculated.
The vaccine has never been associated with heart trouble, but as a
precaution, the Centers for Disease Control and Prevention is advising
people with a history of heart disease not to be vaccinated until further
investigation is complete.
CDC officials said Thursday there was some evidence the smallpox vaccine
has played a role in heart inflammation. They were less certain whether
three recent heart attacks were related to the vaccine.
In New York state, officials halted smallpox vaccinations altogether while
the heart disease issue is sorted out.
Also Thursday, an expert panel advising CDC raised questions about the
government's vaccination program.
The Institute of Medicine suggested the CDC was moving too quickly beyond
its first stage of vaccinations, which include public health and hospital
workers, into a second stage, which includes a large group of emergency
responders. The report, released Thursday, also called on the federal
government to compensate people injured by the vaccine.
On Capitol Hill, lawmakers struggled to do just that, but a House vote
scheduled for Thursday was abruptly canceled amid questions about whether
Republicans had enough votes to beat back a somewhat larger Democratic
compensation plan.
The issue of smallpox vaccine safety gained new urgency this week after a
Maryland nurse died Sunday of a heart attack, and the CDC launched an
inquiry on a possible connection between heart disease and the vaccine.
The second death came Wednesday to Virginia Jorgensen, 57, of St.
Petersburg, Fla., who was a nurse's aide at a local hospital. She suffered
a heart attack about two weeks after being vaccinated against smallpox.
Like the other vaccine recipients with heart troubles, Jorgensen had a
history of high blood pressure and other factors that put her at risk for
heart attack.
"She's been having heart problems for almost a year," her husband, Robert
Jorgensen, said in an interview Thursday. After the vaccination, he said,
"within a few days she was feeling like she had a cold coming on and then
it got bad."
The recent deaths "display a sense of urgency" and make it plain
legislation is needed, said Rep. Richard Burr, R-N.C., the chief sponsor of
the Republican legislative package.
The latest GOP version would pay about $262,000 if a person dies or is
permanently and totally disabled by the vaccine. Those less severely
injured could receive up to $50,000 per year in lost wages, up to $262,000.
They could also get unpaid medical expenses.
Democrats want more for lost wages and want funding for the program
guaranteed.
On the question of heart problems, CDC officials are investigating 17
cases, including seven civilians and 10 people vaccinated in the military
program. The civilian cases include three women who had heart attacks --
two of whom died -- and two with angina, or chest pain. The last two
suffered heart inflammation, and all 10 military vaccinees suffered heart
inflammation.
Federal officials see some evidence that the vaccine is playing a role in
these inflammation cases, said Walter Orenstein, director of the CDC's
National Immunization Program. He said there were reports from decades ago
in Europe of similar problems with another strain of smallpox vaccine. They
are less convinced that the heart attacks and angina cases are related, he
said.
"This very well could be coincidental," Orenstein said.
The vaccine carries well-documented side effects, but they have never
included heart problems. Still, the data were gathered years ago during a
time when most people being vaccinated were young children not likely to
have heart trouble.
The CDC was consulting with cardiac experts on to consider whether
something in the vaccine might be triggering heart problems in people who
already have risk factors.
Existing guidelines already screen out people with conditions that are
known to increase the chances of side effects, including people with HIV,
pregnant women, organ transplant recipients and people with a history of
skin disorders.
The smallpox vaccination program has gotten off to a slow start. As of
March 21, states had vaccinated just over 25,000 civilians, mostly in
public health departments and hospitals. Concerns about the vaccine's risk
have helped keep the numbers well below the 450,000 initially expected.
Several hundred thousand military personnel have been vaccinated.
Based on studies in the late 1960s, experts estimate that one or two people
out of every million being vaccinated for the first time will die. The
death rate for those being revaccinated was lower: Two people died out of
8.5 million who were revaccinated in a 1968 study.
Additionally, 14 to 52 people out of every million being vaccinated for the
first time are expected to suffer life-threatening side effects.
That's because the smallpox vaccine is made with a live virus called
vaccinia, a cousin to smallpox which can cause illness if it escapes the
inoculation site and infects another part of the body. Vaccinia can also
infect those who touch someone else's vaccination site.
------------------------------------------------------------------------
Associated Press writer Rachel La Corte in Tampa, Fla., contributed to this
report.