Smallpox vaccination halted after recent deaths

By Warren King
Seattle Times medical reporter

4/1/03


Smallpox vaccinations statewide were suspended for two weeks yesterday while health officials warn clinics that no one with a history of heart problems should be inoculated.

The action comes after numerous cases of heart inflammation, including three deaths, have been reported in vaccine recipients in other states.

The Centers for Disease Control and Prevention (CDC) issued a string of advisories last week about the incidents, which are being investigated to see whether there is a link to the vaccine.

"People who are getting the vaccinations need time to get the information and to think about it," Jac Davies, state assistant secretary of health, said yesterday.

Almost 400 public-health and hospital workers statewide already have received the vaccinations as protection against a potential terrorist attack with the smallpox virus. They are being advised of the warning.

An effort to inoculate about 500 health workers in King County began last week through hospitals and public-health clinics; it was expected to take about six weeks.

Questions about heart problems also are being added to the list that is checked before someone receives the inoculation, Davies said.

King County officials said one health worker vaccinated last week later had what appeared to be mild heart-attack symptoms. But his private physician determined the problem was not heart-related and not linked to his vaccination, said Dr. Jeff Duchin, director of communicable-disease control for Public Health — Seattle & King County.

At least eight other states also have suspended vaccinations while experts investigate the problem. They include Idaho, Arizona, California, Illinois, Maine, Michigan, New York and Vermont.

While the CDC investigates the vaccination link, it recently added heart-disease risk factors — smoking, high cholesterol and diabetes — as reasons to defer vaccination.

Earlier the agency had warned against inoculations for those with a previous heart attack, chest pain, congestive heart failure or cardiomyopathy, severe swelling of the heart muscle.

Vaccination of civilian health workers — those likely to see the first smallpox patients — is the first stage of a federal program that has struggled to get under way.

Officials estimated that about 500,000 people would volunteer in the first stage, but so far only about 27,000 have stepped forward as worries about the vaccine's side effects have outweighed the unknown terrorist threat.

Experts estimate as many as 52 people of every 1 million vaccinated for the first time would have life-threatening reactions, and one or two would die.

A bill calling for compensation of people injured or killed by the smallpox vaccine was defeated in the U.S. House of Representatives yesterday amid debate over the size of the payments and the package of benefits.

Despite widespread agreement that compensation is needed for people injured or killed by the vaccine, which carries rare but serious risks, the House has been unable to agree on a package of benefits, according to The Associated Press.

Warren King: 206-464-2247 or wking@seattletimes.com