The Bush administration shouldn’t follow through on plans to offer smallpox vaccinations to 10 million emergency workers because of previously unknown and potentially dangerous cardiac side effects, a federal health advisory committee said Thursday.
The Advisory Committee on Immunization Practices said the government should continue the first phase of the smallpox shot program, which seeks to inoculate 450,000 civilian health workers.
But it said it would be unwise to expand the program to millions of police officers, firefighters and other first responders because of the risk of heart inflammation, which the committee called “a new and unanticipated safety concern.”
Health officials had previously known that the vaccine, made with a live virus, carries a small risk of life-threatening complications that kill one or two people out of every million vaccinated.
The committee sent a resolution to its parent body, the Centers for Disease Control and Prevention CDC Director Dr. Julie Gerberding said Thursday she had not received the resolution.
“I don’t think I hear anything that says, ‘Stop the program,'” she said. “The question of how broad the program is something we must pay attention to. It’s absolutely clear we must have preparedness in public health and response teams if we have any hope of mitigating a smallpox attack.”
Smallpox was declared eradicated from the world in 1980 but U.S. officials believe it still could be used as a bioterror weapon.
Dr. Walter Orenstein, director of the CDC’s national immunization program, said several federal agencies probably will have to discuss the resolution because of the national security concerns.
“We need to remember that vaccine isn’t the only defense against smallpox,” Orenstein said. “Isolation is critical” and better education, training and disease surveillance are needed, he said.
Only about 37,600 civilian health workers less than 10 percent of the goal have volunteered to be vaccinated under the federal program since it began in January.
Of those, there have been four probable and 18 suspected cases of heart inflammation or myo/pericarditis reported, according to the advisory committee.
Of the more than 450,000 people in the military vaccinated since Bush’s authorization in December, there has been one confirmed case of the heart condition and about 35 probable or suspected cases.
Six people in the civilian program have had heart attacks, and two of those victims died. Gerberding said Thursday that the heart attacks are “most likely a coincidence and not directly associated with the vaccine.”
Federal officials recently said many states have accomplished the first phase of the Bush plan and are reviewing the steps needed for the next phase that would include the first responders.
CDC officials this week said that there aren’t enough health workers to properly respond to a smallpox attack, meaning hospitals may have to use unvaccinated staff, the officials said.
Gerberding said it would be a mistake for health officials to think that the threat of a smallpox attack has decreased because major fighting in the Iraq war has ended and terrorist threat levels have been lowered.
“It’s tempting to somehow think the smallpox risk has miraculously evaporated but that’s not true,” she said.