Vermont Plans To Vaccinate Smallpox Response Teams

For Immediate Release
December 6, 2002
News media contact:
Nancy Erickson
Vermont Department of Health

BURLINGTON—On Monday, Dec. 9, the Vermont Department of Health, on behalf of the State, will file with the Centers for Disease Control and Prevention (CDC) Vermont’s plan for vaccinating public health and health care response teams against smallpox. The program could include vaccinating up to 2,000 public health and health care workers statewide.

“This is part of a national effort.,” said Health Commissioner Jan K. Carney, M.D. “The possibility of an intentional release of smallpox virus is still considered low, but because the consequences would be so serious, we must be ready to quickly and effectively respond to even a single case.”

Each state was asked to submit its plan to CDC by December 9. CDC must review and approve each plan before the vaccination process can begin. After the Vermont plan is approved and the necessary vaccine is released by CDC, vaccinations could begin as early as January. Only a limited number of public health and health care providers will be eligible, and participation will be voluntary.

Over the next few weeks, the Vermont Department of Health will be working closely with the state’s hospitals and the Vermont Association of Hospitals and Health Systems to identify and educate potential health care response team members. Likewise, the Health Department will be drawing the public health response team from its own workforce.

CDC has requested that states submit these plans for implementing what is called “Phase 1” of the National Smallpox Vaccination Program. At this time the federal government has not yet made a decision to begin vaccinating anyone, and no vaccine has been issued to the states. However, the U.S. Department of Health and Human Services is considering “pre-event” vaccination—vaccination that takes place before there is a confirmed case or outbreak. This pre-event National Smallpox Vaccination Program could potentially proceed in three phases:

The plans currently being submitted to CDC address Phase 1. In these plans, each state and a few large cities have been asked to include estimates of the number of doses of vaccine that would be needed to protect those people who would be initially called upon to respond in the event of a smallpox outbreak. These plans must also detail how these response teams would be identified, how they would be screened to make sure they have no contraindications to the vaccine, and how vaccinations would be administered and then monitored for adverse reactions.

A separate plan, describing how Vermont would respond to a case of smallpox, has also been developed by the Vermont Department of Health and was submitted to CDC on Dec. 1.

Vermont’s Phase 1 plan includes the request for 2,000 doses of vaccine to be administered by trained public health nurses at four Health Department district office clinic sites.

“This is our request and our plan,” said Dr. Carney, “but we will not know the actual number of doses allotted to us until we are notified by CDC. Our plan is designed so that we can readily scale up or down, depending upon the situation.”

About smallpox and smallpox vaccine

Smallpox is a serious, contagious, sometimes fatal disease caused by the variola virus, which emerged in human populations thousands of years ago. Historically, smallpox kills 30 percent of unvaccinated people who develop symptoms.

Smallpox was eradicated in 1980 following a successful worldwide vaccination program. No one on earth has contracted natural smallpox since 1977. The last case of smallpox in the United States was in 1949; Vermont’s last case was in 1937. In the United States, routine vaccination among the general public was discontinued in 1972, when the risk of serious adverse reaction (including death) from the vaccine outweighed the actual threat of disease.

The smallpox vaccine helps the body develop immunity to the virus. The vaccine is made from a closely related virus called vaccinia. The vaccine does not contain the smallpox virus, and cannot give the vaccinated person smallpox disease. According to CDC, the first dose of the vaccine provides protection for three to five years, and decreasing immunity thereafter. If a person is vaccinated again later, immunity lasts longer. Historically, the vaccine has been effective in preventing smallpox infection in 95 percent of those vaccinated.

There is no proven treatment for smallpox disease, but research to evaluate new antiviral drugs is ongoing. According to CDC, vaccination within three days of exposure will prevent or greatly lessen the severity of symptoms in the vast majority of people.

For most people, smallpox vaccine has been safe and effective. But because it is produced from a living virus, vaccinia, the vaccine can infect and harm some people. In the past, between 14 and 52 people per 1 million vaccinated experienced potentially life-threatening reactions. Careful screening of potential recipients is essential to ensure that those at increased risk do not receive the vaccine.

Women who are pregnant or planning to become pregnant, people who live with someone less than 1 year old, people with eczema, HIV/AIDS patients, organ-transplant recipients, and chemotherapy patients should NOT be vaccinated, unless they have been exposed to smallpox.