Posted on: Friday, January 31, 2003

4 hospitals resist smallpox vaccinations

By Robbie Dingeman
Advertiser Health Writer

Four of 32 hospitals statewide have declined so far to participate in the state's program to offer voluntary smallpox vaccination to Hawai'i healthcare workers to prepare against a possible bioterrorist attack, according to local health officials.

The four hospitals that have yet to commit to the voluntary vaccinations have expressed concerns about legal liability issues linked to the inoculation, according to Toby Clairmont, emergency program manager for the Healthcare Association of Hawai'i.

The four hospitals yet to sign on are: Castle Medical Center in Kailua; the Hawai'i State Hospital in Kane'ohe; North Hawai'i Community Hospital in Waimea on the Big Island; and Shriners Hospital for Children in Honolulu.

The association and the state Health Department said 90 percent of Hawai'i's hospitals have agreed to participate, placing the state above the Mainland average of about 60 percent.

Even if the four Hawai'i hospitals opt out of the voluntary vaccination program, there would be no public health problem in the event of an outbreak of the disease, said state Health Department spokeswoman Janice Okubo. "We feel like we'll have enough people on smallpox response teams to be able to respond to any emergency."

Clairmont emphasized that all 42 Hawai'i hospitals will still take part in smallpox response preparation, and will receive protective gear, training and more. "They're doing the planning but they haven't yet decided whether they want to offer the smallpox vaccination to their staff."

Stan Berry, president and chief executive officer at North Hawai'i Community Hospital, said officials there are consulting with their medical staff and getting advice from their corporate management company, Adventist Health, based in Roseville, Calif., before making a final decision.

Other hospitals and unions for medical workers on the Mainland have raised concerns about legal responsibilities if their workers have a bad reaction to the vaccine. Early vaccination efforts have received lukewarm support.

"The whole concern is about the safety of the vaccine," Berry said. "It's been in storage for 30 years. There could be reactions; there could even be death."

Berry said the serious potential side effects and the liability issues make the precautionary vaccination a decision that should be considered carefully while the risk of vaccination as protection during an actual outbreak would be weighed differently.

"There's fairly widespread concern," Berry said. "It's not a patriotic issue, it's making sure we do the right thing."

Adventist Health owns Castle Medical Center and has advised its hospitals that there are unanswered questions about legal liability, according to Castle marketing director David Earles.

"We don't feel that the liability issues have been addressed properly in the Homeland Security Act," Earles said. "So, at this time, we are not going to be involved."

Over at Shriners, the decision on participation may come as early as today, according to Anne Kelly, director of patient care services. "We are awaiting a corporate decision," she said, from Shriners headquarters in Tampa, Fla.

Okubo said officials at the state-run hospital declined to participate because, as a psychiatric facility, "they didn't feel that smallpox patients would come to their hospital."

Clairmont said he thinks it's logical that some hospitals may take longer to make the decision on the vaccination program. If they take the time to consult more people and carefully weigh their choice, Clairmont said, "a slower decision is probably a better decision in this case."