Yale-New Haven Hospital administered its first smallpox vaccinations Wednesday as part of a statewide program to prepare for a possible bioterrorist attack.
About 15 health care workers at the hospital were given the vaccine, making them among the first in the country to be inoculated as part of a nationwide program to prepare communities for a potential smallpox outbreak. Connecticut, which in January became the first state to vaccinate volunteers, will inoculate about 1,000 hospital workers against the potentially deadly virus by early April.
Christopher Cannon EPH ’79, director of the Yale-New Haven Hospital System’s Office of Emergency Preparedness, said he was pleased that all 32 acute-care hospitals in the state had agreed to participate in the smallpox vaccination program. Yet he said it was unlikely that the state would have enough volunteers to use all 6,400 of the doses allocated to it by the federal government’s Centers for Disease Control and Prevention.
“It’s better than we first thought, but it’s not as many as I think we’d like to have,” said Cannon, who has helped organize the statewide vaccination program.
Three weeks ago, the Bush administration announced its intentions to have 500,000 health care workers vaccinated against the disease, which has a mortality rate as high as 30 percent among patients who do not receive the vaccine. Because the vaccine must be administered no later than four days after infection to be fully effective, health officials have been developing plans for a rapid emergency response in case of an attack.
Yet concerns over the side effects — which caused death in about one to two people out of every million vaccinated in the 1960s — have already led over 350 hospitals across the country to decline participation in the program. Given these concerns, Cannon said he was confident in Connecticut’s ability to create several teams of about 150 inoculated volunteers who would respond to an attack.
“The reality is that we’ll be able to have the smallpox response teams in the state that we’ll need,” Cannon said.
Participation has been limited not only because of the side effects, which more frequently include skin rashs and flu-like symptoms, but also because many hospital workers are not eligible to receive the vaccinations. Conditions that currently prohibit vaccination include skin disorders or pregnancy, and since volunteers for the shots cannot share a household with anyone with one of the prohibited conditions, as many as 30 to 50 million Americans are ineligible to receive the vaccine, Cannon said.
Volunteers who were vaccinated before the disease was eradicated in the late 1970s are still required to receive the shots, as the inoculation’s effectiveness may diminish after several decades.
Louise-Marie Dembry, a Yale epidemiology professor who helped direct the vaccinations at Yale-New Haven Hospital, said the shots were administered without any problems.
“I am comfortable with the number of people who have gone through the education programs and the screening, and they are comfortable with their decisions,” Dembry said.
Before the vaccinations, potential volunteers attended educational sessions explaining the risks and benefits of the inoculations. All interested workers were then required to complete rigorous one-on-one interviews to ensure that they were eligible, Dembry said.
William Quinn, the director of the New Haven Health Department, said he currently spends about 70 percent of his time working on issues concerning bioterrorism. The city has created a basic plan in the case of an attack — Hillhouse, Wilbur Cross, and Hill Regional Career high schools would serve as clinics — but Quinn said the city’s budget for bioterrorism preparedness was insufficient.
“Locally, the funding’s not enough,” Quinn said. “There’s no question about that.”
He also said issues concerning liability had complicated the city’s efforts to recruit volunteers who would be willing to get vaccinated.
“Given all the questions that are still unanswered, Connecticut and New Haven are doing very well,” Quinn said.
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