HHS Is Thinking Big about smallpox.(LETTERS)

The Washington Times (Washington, DC), June 28, 2002 | Go to article overview
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HHS Is Thinking Big about smallpox.(LETTERS)


Byline: THE WASHINGTON TIMES

On June 20, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention delivered recommendations to the Department of Health and Human Services (HHS) that expand the current smallpox vaccination policy. In addition to laboratory personnel working with smallpox, these recommendations broaden the existing smallpox vaccination policy to include those individuals who would be most likely to come in contact with smallpox victims in the event of a biological attack.

Charles V. Pena's "Small thinking on smallpox" (Commentary, June 20) criticizes the revised ACIP smallpox vaccination recommendations as misguided and manifesting a lack of knowledge about the complexity of the issues that demand address. Specific criticisms of direct quotes taken from Mr. Pena's article include:

Error No. 1: "The Centers for Disease Control and Prevention (CDC) are meeting behind closed doors." Not true. During the past month, public forums were held in New York City, San Francisco, San Antonio, St. Louis and Washington. Furthermore, the ACIP meeting held in Atlanta on June 19 and 20 welcomed and received public comment.

Error No. 2: "The bottom line is that an unvaccinated population is completely vulnerable and an attractive target. A better approach than leaving the population exposed would be to take preventative measures." This is untrue and dangerously misleading.

The smallpox vaccine, vaccinia, is a live virus that is closely related to smallpox. Vaccines are infectious and may unintentionally transmit the virus to individuals who may develop life-threatening complications. Because there is a risk of endangering others, this is not simply an issue of an individual's right to choose. The health of the American public must be our primary concern.

The smallpox vaccine is the least safe vaccine ever used in the United States, with 2 to 4 deaths per million vaccines and another 3,000 severe and potentially disabling complications expected. The vaccines available are currently labeled as "Investigational New Drugs" that require the approval of an Institutional Review Board (IRB) for participation in clinical trials. Appropriate informed consent, screening, patient follow-up and administrative oversight by federal, state and local public health officials would be required, as well as policy decisions regarding a host of legal and procedural issues, including responsibility for liability and costs incurred.

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