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Military Personnel Suffer More Heart Troubles Than Expected After Smallpox Vaccinations, Researcher Says

By Chris Schneidmiller
Global Security Newswire

WASHINGTON — More than 70 people suffered heart troubles after receiving smallpox vaccinations from the U.S. Defense Department, a surprisingly high figure compared to the limited cases of other health problems linked to those inoculations, a Walter Reed Army Medical Center researcher said this week (see GSN, April 13).

“Reported rates of noncardiac complications have been very low, in line with the rates of complications we saw historically, when children were routinely vaccinated for smallpox,” Dimitri Cassimatis, a Walter Reed cardiology fellow, said in a prepared statement on his clinical review of reactions to smallpox vaccinations among military personnel. “The rate of cardiac complications, however, has been higher than expected,” he added.

The American Medical Society today presented Cassimatis’ review, which was finished last summer.

More than 615,000 military personnel, contractors and “emergency-essential civilians” have received smallpox vaccinations since the Pentagon began inoculations in January 2003 in an effort to protect its forces from biological attack (see GSN, Oct. 23, 2003). Seventy-seven men and women subsequently suffered from myopericarditis — inflammation of the heart muscle or the sac around the heart, the department said in April.

As of April 30, 21 civilians had also contracted the heart condition amongst the 39,500 U.S. medical professionals who have been vaccinated, according to the Centers for Disease Control and Prevention.

In addition, the British biotechnology company Acambis last month halted enrollment for clinical trials on a new smallpox vaccine last month after three people contracted myopericarditis.

No deaths have been connected to the heart illness when brought on by the vaccination.

Something about the vaccine causes a “cross-reaction” that triggers the heart response, Cassimatis told Global Security Newswire. The exact cause remains under investigation, said CDC spokesman Von Roebuck.

Myopericarditis causes continuous chest pains that can last for “hours and often days,” Cassimatis said. Patients experience fatigue, shortness of breath and heart palpitations. The heart trouble becomes serious only for a small percentage of patients, and will usually dissipate naturally over a period of weeks, he said.

The rate of incidence for myopericarditis in the armed forces in 2002, prior to vaccinations, was two per 100,000 people every 30 days, Cassimatis said. That rate was maintained for military personnel who had previously been inoculated against smallpox; however, those being vaccinated for the first time saw an incidence rate of 16 per 100,000 over 30 days. “That’s about a 7 1/2-fold increase for primary vaccinations,” he said.

Military personnel received anti-inflammatory drugs and were barred from “high-level exertion” for several weeks while recovering, Cassimatis said. Most returned to full health.

Myopericarditis was by far the most prevalent health side effect linked to the smallpox vaccinations, the Defense Department reported.

A 22-year-old U.S. Army reservist died last year after receiving vaccinations against smallpox and other diseases. Two panels of experts concluded that the inoculations likely caused her death from a “lupus-like illness,” but they were unable to identify a specific shot as the fatal agent.

Post-vaccination deaths of five other military personnel were not caused by the smallpox treatments, the department said.

The Pentagon also reported 36 cases of generalized vaccinia — a widespread rash and sores caused by the injection ð— and 34 cases in which the infection from the smallpox shot was transferred by contact to another person.

There were 24 civilian cases in which a health worker spread the infection to another part of the body by touching the vaccination site and then an eye or another body part, the CDC reported. The agency also found one case of brain swelling and three incidents of generalized vaccinia among inoculated civilians.

Cassimatis said he hopes in coming months to organize a study of 600 to 800 people who would receive the smallpox vaccination. By studying the group over a period of weeks, he hopes to better learn who is at risk for heart problems and why it occurs after inoculations.

Smallpox vaccinations would continue as needed, the CDC and Defense Department said. Mass injections can be performed safely through staff training, patient education, screening out of people with medical conditions that could make vaccinations dangerous and attention to bandaging, officials said.

“We feel it’s very much of importance to have people vaccinated before a smallpox event,” Roebuck said. “We hope we never have to see it, but if it’s there we’ll have a plan to deal with it and folks who have been vaccinated can help from the very beginning” (see related GSN story, today).