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Second Death Halts State Smallpox Shots

Mar 28, 2003 | South Florida Sun-Sentinel Florida has indefinitely stopped giving smallpox inoculations to hospital emergency room workers while federal officials study whether the vaccine contributed to the heart-related death of a St. Petersburg nurse's aide.

The aide, 57, on Wednesday became the second vaccine recipient to die of a heart attack, and 15 others across the country and in the military have developed heart problems within 17 days of a smallpox shot.

Heart disease has never been a known side effect of the vaccine made of a live virus related to smallpox and so far there's no evidence that it caused the problems in the 17 people, said Walter Orenstein, immunization director at the U.S. Centers for Disease Control and Prevention.

But the cluster of cases justifies extra precautions until federal health officials determine whether the vaccine is related to heart incidents, Dr. John Agwunobi, the Florida secretary of health, said in a statement.

Until its program was halted, Florida led the nation in smallpox inoculations. Since the vaccine became available in February, 3,149 Florida hospital workers and health department employees had received shots as of March 21 out of 25,645 civilians nationwide, only a fraction of the numbers originally expected. About 225,000 military personnel have had the shots.

Slowed to a stop

State vaccinations for emergency room workers had been underway for just over four weeks and were almost done. The Broward County Health Department stopped giving shots until at least Monday and the Palm Beach County Health Department, not vaccinating presently, canceled shots that were set to resume on April 3.

"Those are the last ones," said Timothy O'Connor, a department spokesman in Palm Beach County. "We're pretty much wrapped up with the hospital group."

The next group slated for shots is paramedics, police officers, firefighters and other hospital workers who would respond to victims of a smallpox attack. The CDC said it's unclear when that phase of the vaccine program would start.

The St. Petersburg aide's identity was confirmed by her family as Virginia Jorgensen, 57, who like the other 16 affected vaccine recipients had a history of heart trouble. The group had problems such as poorly controlled diabetes, high blood pressure, high cholesterol, obesity, smoking and stroke that put them at elevated risk for a heart attack.

The CDC said Jorgensen had been a smoker with high blood pressure and chronic obstructive pulmonary disease, which includes emphysema and bronchitis.

"She's been having heart problems for almost a year," her husband, Robert Jorgensen, told The Associated Press. "It just seems odd the way it came up. Within a few days [of the shot], she was feeling like she had a cold coming on and then it got bad."

Jorgensen was among the first hospital workers vaccinated in Florida. On March 4, six days after getting her shot, she went to the emergency room with an exacerbation of her lung trouble and dehydration, the CDC said. While being treated, she had a minor stroke but got better and went home.

On March 16, she had a heart attack at home and went untreated for 10 to 20 minutes before paramedics came, the CDC said. She never recovered.

Coincidence or victims?

A Maryland woman, 50, died of a heart attack four days after a vaccination and a third woman, 54, recovered from a heart attack nine days after her shot.

Two inoculated people developed angina, or chest pain, and 12 others including 10 military personnel were found to have inflammation of the heart muscle or the covering around the heart.

"This very well could be coincidental," Orenstein said. Heart disease is so prevalent that these people could have had heart trouble regardless of the vaccine, he said.

As a precaution, the CDC on Tuesday recommended that people with past heart ailments not be vaccinated, just as it has cautioned pregnant women and people with skin disorders or weakened immune systems, who are known to be vulnerable to vaccine side effects.

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