Smallpox vaccination decision in White House hands

Sep 4, 2002 (CIDRAP News) – The Department of Health and Human Services (HHS) recently sent a recommendation on smallpox vaccination policy to President Bush, but HHS officials still are not confirming reports that it calls for vaccinating as many as 500,000 healthcare workers.

"I can't confirm anything other than that the recommendation went to the White House," Bill Pierce, an HHS spokesman in Washington, DC, told CIDRAP News today.

In a Washington Post report today, HHS Secretary Tommy Thompson was quoted as saying that a decision on the vaccination policy will be made sometime this month. The article quoted unnamed officials as saying that the recommendation calls for a multiphase vaccination program that could involve as many as a half-million hospital workers considered most at risk in the event of a bioterrorist attack.

In June, the Advisory Committee on Immunization Practices (ACIP) recommended smallpox vaccinations for healthcare workers assigned to outbreak-response teams and for some staff members in hospitals preassigned to take smallpox patients in case of an outbreak. At the time, ACIP Chairman John F. Modlin, MD, estimated that 10,000 to 20,000 people could be vaccinated under the plan. But in early July, D. A. Henderson, HHS's senior advisor on public health preparedness, and Jerome A. Hauer, acting assistant secretary for public health preparedness, estimated that the number affected could exceed 500,000. However, other HHS officials subsequently said the number had not yet been determined.

Today's Washington Post report said Thomspon refused to give the details of the HHS recommendation, but it said he has concluded that the federal government should assume liability for any adverse side effects of the vaccine. It is estimated that the vaccine would be fatal for about 1 in 1 million recipients.

The ACIP, which advises the Centers for Disease Control and Prevention, concluded that the risk of a terrorist attack with smallpox is low and that the risks of vaccinating the general public therefore outweigh the potential benefits.

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