February 12, 2003

Troops shun anthrax jab

Richard Norton-Taylor
The Guardian

More than half the armed forces personnel deploying to the Gulf have refused to be vaccinated against anthrax, the Ministry of Defence has disclosed. Though the vaccinations are voluntary, the ministry strongly recommends their use. The low take-up appears to reflect concern among troops about the side effects of the anthrax vaccine.

Military commanders have been warned by the intelligence services to anticipate chemical and biological attacks ordered by Saddam Hussein in the event of an invasion of Iraq.

Of around 16,500 armed forces service personnel offered anthrax jabs, only 8,103 have accepted, according to the junior defence minister, Lewis Moonie.

In a letter to Paul Keetch, the Liberal Democrat defence spokesman, he said anthrax represented a "real threat to our armed forces".

But he added that despite having "no reservations about recommending it", immunisation would remain voluntary "in accordance with long-standing medical practice."

Defence officials admitted yesterday that military operations could be disrupted if only some members of a unit were vaccinated.

Mr Keetch accused the government of sowing confusion and exhibiting a lack of leadership. "Over half our servicemen and women in the Gulf will now not be protected against the possibility of an anthrax attack," he said.

"Soldiers are being asked to judge for themselves the possibility of anthrax infection in the Gulf. If the vaccine is safe and the threat real, why pass the buck to our troops to decide?"

The ministry said yesterday that an internal investigation into how dozens of phials of anthrax vaccine were found washed up on a Dorset beach confirmed that they came from military supplies.

Specialist British army units who would be responsible for attacking or decontaminating suspect chemical and biological sites have been given smallpox vaccine. This carries a greater, though still minimal, risk to the individual than anthrax jabs, according to defence officials. They said that smallpox and anthrax vaccinations were compulsory in the US armed forces.

International relief agencies are unprepared to deal with the consequences of a chemical or biological attack on a civilian population in Iraq, the London School of Hygiene and Tropical Medicine has warned.

February 3, 2003

Little Rock hospital balks at providing vaccinations

The Associated Press

One of the major hospitals in the state's largest city has balked at the idea of providing smallpox vaccinations to health-care workers, because of possible risk to patients.

Officials of the St. Vincent Health System, which operates St. Vincent Infirmary Medical Center, said it will not participate when the state Health Department begins providing smallpox vaccinations to designated health-care workers Feb. 19.

In addition to St. Vincent Infirmary Medical Center, the flagship operation, the system operates St. Vincent Doctors Hospital at Little Rock, as well as hospitals at Sherwood and Morrilton. The possibility of accidentally infecting patients is too great, St. Vincent officials said.

"We believe it -- the voluntary vaccination program -- is a greater risk than benefit," said Margaret Preston, a St. Vincent spokesman. "If those circumstances change, then, obviously, we would change our position."

The federal Centers for Disease Control and Prevention warns that the vaccine can, in rare cases, cause serious side-effects or even death. The agency recommends that anyone in close contact with someone with a weakened immune system should not get the vaccine.

"If hospital employees who have been vaccinated will use proper infection-control guidelines, there should not be a problem," said Beth Ingram, vice president of the Arkansas Hospital Association.

So far, the St. Vincent hospitals are the only Arkansas facilities to opt out of the program.

Except for St. Vincent, all of Arkansas' acute-care hospitals have requested information packets to help their personnel decide whether to participate in the smallpox vaccination program. Arkansas hospitals have until Feb. 14 to submit to the Health Department the number of doses they will need to vaccinate their first responders.

Ingram said Arkansas hospitals remain wary. The federal Homeland Security Act includes a section addressing some liability concerns, but there are some gray areas.

Ingram said hospitals are still unsure whether sick leave for employees who suffer significant adverse reactions to the vaccine would be covered under workers' compensation.

"The sticking point is that it is a voluntary program, and it's not mandated" for their jobs, she said.

Some hospitals say their employee health insurers have warned that illnesses stemming from vaccination may not be covered, Ingram said.

The Health Department, the Workers Compensation Commission and the state Insurance Department are drafting a bill that will address some of the liability concerns, said Mike Pickens, the state insurance commissioner.

Policymakers Look to Create Fund for Those Harmed by Smallpox Vaccine

Health Care Policy Report

The Bush administration and members of Congress Jan. 24 signalled support for creating a fund to compensate those who suffer side effects from smallpox vaccinations.

Meanwhile, the first smallpox vaccinations under President Bush's plan to protect against biological attack began in Connecticut Jan. 24. Under Bush's plan, state health departments will urge vaccinations for about 439,000 health care workers who would be designated to staff volunteer smallpox response teams. After these initial teams are vaccinated, the administration plans to offer the vaccine to 10 million emergency responders, including fire and police personnel and other health workers. A mandatory vaccination program already is under way for certain military personnel.

For every 1 million people receiving the smallpox vaccine, one to two deaths can be expected and an additional 14-52 life-threatening events can be expected, according to estimates from federal health officials.

"There is a possibility that there will be some sort of fund set up," Department of Health and Human Services Secretary Tommy G. Thompson told reporters after speaking to the U.S. Conference of Mayors Jan. 24.

Thompson said administration officials had been talking to leadership on Capitol Hill about creating a compensation fund.

Top Republican leaders in the Senate on health care policy have agreed to work together on legislation establishing such a fund, according to a GOP leadership aide.

Senate Democrats Favor Compensation Fund

A group of 22 Senate Democrats wrote to President Bush Jan. 22, saying that those who volunteer to be vaccinated and suffer side effects deserve to be compensated.
"We are writing to express our dismay at your Administration's proposal to vaccinate millions of Americans against smallpox without assuring that persons injured by the vaccine will receive medical care and fair compensation," the senators wrote. Sen. Edward M. Kennedy (D-Mass.), the ranking Democrat on the Senate Health, Education, Labor, and Pensions Committee, was the leading signatory to the letter.

Senate Majority Leader Bill Frist (R-Tenn.), Kennedy, and HELP Committee Chairman Judd Gregg (R-N.H.) agreed during a Jan. 23 colloquy on the Senate floor to collaborate with one another on the issue, according to Nick Smith, spokesman for Frist.

"Senator Frist believes there needs to be appropriate compensation" and wants to work on it with Gregg and Kennedy, Smith told BNA Jan. 25.

Frist said in a December 2002 speech that policymakers should weigh creating such a fund. He noted that, in 1986, the government created a Vaccine Injury Compensation Program, but that program only compensates the families of children suffering from vaccine side effects.

Must Prove Negligence

The homeland security law allows damages to be paid to those suffering side effects from the smallpox vaccine. However, the law requires that the injured person or his or her family prove negligence in administering the vaccine or the making of the vaccine in order to obtain compensation.

The first smallpox vaccinations for health care workers had to wait until Jan. 24 when liability safeguards for those administering the vaccine and vaccine makers kicked in under the recently enacted Homeland Security Act of 2002 (Pub. L. No. 107-296).

In his December speech, Frist said he supported the liability safeguards in the homeland security law for those administering and making the smallpox vaccine. However, Frist said that the provisions do nothing to assuage health professionals' concerns about administering future vaccines protecting against other dangerous agents like anthrax.

Frist urged legislation that "more globally" provides liability safeguards for those administering vaccines to protect Americans against dangerous biological agents, so that Congress will not need to act in an ad hoc manner every time the issue arises.

February 2, 2003

Soldier suffers reaction to smallpox shot

Milwaukee Journal Sentinel

Washington -- One soldier inoculated against smallpox has suffered a potentially serious skin reaction to the vaccine, and officials are investigating whether a second ill soldier also is reacting to the shot, the Pentagon said Friday.

It was the first report of any serious reaction to Americans receiving the vaccinations, which began in December for the military and are just now getting under way for civilians. The first case, a 30-year-old Army soldier at a U.S. base, was a skin reaction called generalized vaccinia, and officials were confident it was linked to the man's vaccination 10 days earlier.

In the second case, a 26-year-old Army soldier was admitted to an overseas military hospital for encephalitis, a brain disease that can cause paralysis or permanent neurological damage. Diagnostic studies could not confirm that his reaction was due to his smallpox vaccination. But he had received the vaccination eight days earlier.

Both men now are in good condition, the Pentagon said.