Posted on: Friday, January 3, 2003

Response team given smallpox shot

By William Cole
Advertiser Military Writer

For the first time in more than a decade, and with an eye toward bioterrorism concerns, Hawai'i-based military personnel are again being given smallpox vaccinations.

Five service members who would be first responders in the event of a smallpox outbreak were inoculated last week, and 25 to 30 more will receive the vaccine next week as part of a Defense Department initiative to inoculate 500,000 military members.

As many as 3,500 civilian public health and healthcare workers in Hawai'i are expected to be vaccinated, beginning later this month or in February.

The programs are part of national smallpox preparedness plans announced by President Bush to create a first line of defense in the event of a biological attack.

Tripler Army Medical Center spokeswoman Margaret Tippy said smallpox response teams within each service branch in Hawai'i "would be those people that would vaccinate other people" in an emergency.

Routine smallpox vaccinations ended in the United States around 1972, followed by the World Health Organization declaring the global eradication of naturally occurring forms of the disease in 1980.

Military vaccinations in 1984 were limited to recruits entering basic training, but those were discontinued in 1990. After Sept. 11, 2001, and the anthrax attacks, the Defense Department said it "reassessed the threat of a smallpox attack."

"The Department of Defense is establishing a smallpox vaccination program to protect the health and safety of military personnel," Assistant Secretary of Defense for Health Affairs William Winkenwerder said last month. "Smallpox is a serious infectious disease. We cannot quantify the threat of it being used as a bioweapon, (but) we know the consequences of its use could be great."

Tippy said the goal is to have military first responders inoculated by the end of the month. She was not sure how many military members in total are part of the group.

Healthcare workers, including doctors and nurses, who would care for individuals exposed to smallpox will be vaccinated next, followed by "others on a case-by-case basis depending on mission requirements," she said.

Troops likely to face combat if there is a war with Iraq are among those who will receive the vaccinations, which are mandatory unless a health pre-screening points to a likelihood for complications.

According to the Centers for Disease Control and Prevention, smallpox is fatal in up to 30 percent of cases. The vaccine is given by pricking the skin with a two-pronged needle dipped in vaccine solution.

The CDC, which asked each state for a plan to immunize health-care workers, approved Hawai'i's plan Dec. 15, said Health Department spokeswoman Janice Okubo.

Okubo said the state has not yet received the vaccine that, like the military plan, would be given first to individuals who would respond to a smallpox outbreak, and then in a second phase to health-care workers who would staff vaccination clinics in the event of an outbreak.

Civilian vaccinations for smallpox are voluntary.

"We're still working out how the plan will be implemented," Okubo said. "Certainly, we're hoping that many public health and healthcare workers do step forward and get the vaccination so that the state will be prepared in the event there is some type of emergency."

Reach William Cole at wcole@honoluluadvertiser.com or 525-5459.