Scope of smallpox vaccination program not yet decided, HHS officials say

Jul 10, 2002 (CIDRAP News) – Though two top federal health officials recently were quoted as saying that half a million healthcare workers may be vaccinated against smallpox, the official word from the Department of Health and Human Services (HHS) is that the scope of the vaccination program has not yet been decided.

"There's been no decision made, and it's premature to speculate on the numbers," Curtis Allen, a spokesman for the National Immunization Progam at the Centers for Disease Control and Prevention (CDC) in Atlanta, told CIDRAP News yesterday. "We're continuing to solicit input from first responders who have a stake in this issue. We're taking a lot of comments into consideration, but the number of people to be vaccinated has not been determined."

In recent news reports, both D. A. Henderson, MD, HHS's principal science adviser on public health preparedness, and Jerome A. Hauer, acting assistant secretary for public health preparedness, said the number of healthcare workers vaccinated could exceed 500,000. That number is far higher than estimates some officials gave in June, after the Advisory Committee on Immunization Practices (ACIP) issued a recommendation on who should be vaccinated. Henderson's comments were reported in a Jul 7 New York Times report, and Hauer's statements were in a Jul 8 Associated Press story.

On Jun 20, the ACIP recommended smallpox vaccination for healthcare workers assigned to serve on outbreak response teams, and also for some staff members in hospitals preassigned to take smallpox patients in case of an outbreak. The recommendation did not suggest how many people that would be, but said states are to identify the response teams and hospitals in their bioterrorism response plans. But at a Jun 20 press conference, ACIP Chair John F. Modlin, MD, estimated that 10,000 to 20,000 people would be vaccinated. Those numbers, as well as an estimate of 15,000, have been mentioned in numerous news reports.

A statement posted on the National Immunization Program Web site Jul 8 emphasized that no decisions have been made. "The number of people to be vaccinated has not yet been determined," it said. "It will depend on the policy decision as well as input from state and local health officials responsible for bioterrorism planning."

The ACIP recommendation is under review by the CDC, which will advise HHS Secretary Tommy Thompson whether to approve or modify it. Newly appointed CDC Director Julie Gerberding, MD, was quoted in a Jul 7 Associated Press report as saying that the possibility of broadening the vaccination program to healthcare workers other than those mentioned in the ACIP recommendation was being considered. She said hospital associations have been pressing for vaccination of more staff members, according to the report.

Allen, however, declined to offer any specifics on what HHS officials are considering. He also refused to confirm media reports that Thompson will make a decision on the vaccination program by the end of July. "There is no timeline," he said.

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