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medpundit |
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Friday, June 07, 2002"At a meeting last month of members of ACIP and a related body, the National Vaccine Advisory Committee (NVAC), there was little support for making smallpox vaccination available to anyone who wanted it. Nevertheless, there appears to be public support for just that. Interviewers hired by the Harvard School of Public Health and the Robert Wood Johnson Foundation last month asked a sample of 3,000 Americans whether they would get a smallpox vaccination if it were offered. Fifty-nine percent said yes." Evidently, the average man on the street has a better feel for the risks we face than the experts. The article also contains a couple of incorrect assumptions that deserve correcting: "Historically, ring containment worked for smallpox for several reasons. All infections are obvious because of the disease's dramatic, bumpy rash; people don't transmit the virus until the rash appears; and, most important, if someone is vaccinated within seven days of exposure, the risk of becoming infected is reduced substantially (by as much as 70 percent, according to old studies). The disease is less contagious than some viral infections, such as measles and influenza, with data from pre-eradication outbreaks in Asia suggesting that infection usually requires days of close exposure to someone who is sick." There is, actually, a window of two days when a person is infectious but does not yet have a rash. During those two days they may have nothing more than a flu-like illness. Ring containment worked in the eradication campaign because of high levels of background immunity which made it more difficult for the virus to find susceptible hosts. It does not require a few days of close exposure to contract the disease. In a non-immune population it spreads very easily. It is not less infectious than measles or influenza, and even if it were, it is much more fatal. UPDATE II: The Cato Institute and some concerned infectious disease and public health experts are arguing for voluntary vaccination. UPDATE III: The CDC held its public comment forum in New York last night. The consensus there was that they should vaccinate health care workers. That's not surprising, the audience was largely made up of health care workers. The meetings, quite frankly, haven't been widely publicized. I certainly think healthcare workers should be vaccinated, but I don't see why we should deny the same protection to ordinary citizens. They will be at just as much risk in the community, and at even more risk if they happen to be in a hospital or a physician's office where a smallpox patient walks in for treatment. UPDATE IV: I found this great site on the history and basic science of smallpox while web surfing last night. The information is accurate and comprehensive, and it has great pictures. YET ANOTHER UPDATE: Only eight citizens of New York spoke up at the CDC's public forum on the smallpox vaccination. "Only a handful" showed up in contrast to the 150 members of the CDC who were there. That's not so surprising, the media haven't really publicized these forums, which means that the CDC hasn't been sending out press releases about them. Not only that, but they haven't been publicizing the issue at all. There have been few articles on the risks of smallpox or of the vaccine in the popular media. My local paper, which takes most of its national stories from the New York Times, hasn't covered it at all. That's a shame. The CDC could do better than that, if they wanted to. posted by Sydney on 6/07/2002 07:23:00 AM 0 comments 0 Comments: |
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