The needle that delivers smallpox vaccine is only about 3 incheslong, with two tiny prongs at one end. But for legions of healthcare workers nationwide, it symbolizes a complex personal choice.
These doctors, nurses and public health officials must decidewhether to volunteer for the vaccine some as early as Friday sothey could treat patients in a bioterrorist smallpox attack. But thevaccine itself can cause fierce side effects and even sicken othersclose to those vaccinated.
As an emergency-room nurse in Milwaukee, Lisa Hass-Peters knowsshe is a prime candidate for a smallpox response team.
But her husband, Jeff, has had two liver transplants, leaving hisimmune system weakened. That means the smallpox vaccine made from alive virus related to smallpox could make him sick. He could beinfected from the scab on her arm caused by the vaccine.
'I didn't hesitate to decline,' said Hass-Peters, who works atMilwaukee's Froedtert Memorial Lutheran Hospital. 'If I truly wasexposed, I guess I would be weighing my options again. But I don'tfeel a threat at this particular moment.'
The government plans to vaccinate nearly 500,000 health workers.So far, only Connecticut said it was ready to begin vaccinations onFriday, the day a law protecting those giving the shots fromlawsuits takes effect. Los Angeles County, Vermont and Nebraska arethe only other locations that had received the vaccine shipmentsWednesday.
Strictly voluntary, the vaccine is aimed at creating smallpoxresponse teams for treating patients in an attack. But some healthcare workers and hospitals are refusing because of the risks fromthe vaccine itself.
Though in the minority, major hospitals refusing to vaccinatetheir workers range from Colorado's largest chain, Centura Healthwith 10 hospitals, to Grady Memorial Hospital in Atlanta, home ofthe Centers for Disease Control and Prevention, which is shippingvaccine to the states.
The risk of a smallpox attack is unknown, and the chance that anygiven person will be exposed is small, an advisory panel for theInstitute of Medicine said recently in urging the government to goslower with the vaccinations.
But the risks of the vaccine are well-known. Some people may havesore arms and fever or feel sick enough to miss work. As many as 40people out of every million vaccinated for the first time will facelife-threatening reactions, and one or two will die.
The vaccine is not recommended for people with skin problems,such as eczema, or those with weak immune systems, such as HIV,transplant or cancer patients. The government says even people withfamily members in those categories should be screened out.
Health care unions have criticized the Bush administration,accusing it of cutting corners on screening and training. They alsoworry that people who have side effects or miss work may not befully compensated; the government says it is working on a plan.
ON THE WEB
Vaccine facts:
www.bt.cdc.gov /agent/smallpox /vaccination /facts.asp
