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Sunday, December 22, 2002Phase one of the program has gone pretty much as planned, though with a few complications. Probably the most surprising was the reluctance of many health-care workers to get the shots, which pushed back the deadline for the first 15,000 from October to December. "Part of it is a less than satisfactory communications effort. But it's mainly a reluctance to take a chance on getting severe side effects," says Ethan Rubinstein, the head of the infectious diseases unit at Tel HaShomer Hospital in Tel Aviv. Those side effects can include high fever (which can hit 50 out of every million recipients of the vaccine), meningitis (15 per million), and even death (1 per million). The authorities pointed out, however, that most people who are affected in such ways are toddlers, the elderly, or those with weakened immune systems, none of whom would be given the vaccine during the initial inoculation. So far, only four Israelis have been hospitalized in the course of the inoculation: a spouse and child came down with a mild case of cowpox -- from which on version of the smallpox vaccine is made -- and two people had heavy fevers. All are fine now. "My best advice is information, information, information," says Hadari. "Let everyone know exactly how little risk is involved and do everything you can to battle misconceptions." With that in mind, The Washington Post today has a public information piece about the vaccine and the disease. It's not bad, although it doesn't do much to dispel fear of the vaccine, going so far to suggest that people with small children at home shouldn't get the vaccine. That would effectively eliminate vaccinating the most vulnerable segment of the population - those under thirty-five who have never been vaccinated, and would only undermine the goal of pre-attack vaccination. Whoever gave that advice to the Post, and surely they got it from someone in the public health community, should think twice about it before making it a policy. Especially in light of the review that will appear in the New England Journal of Medicine which shows that the vaccinia virus used in the vaccine isn't nearly as contagious as previously believed. This is what the paper's author told the New York Times: In another article, Dr. Kent A. Sepkowitz, director of infection control at Memorial Sloan-Kettering Cancer Center in Manhattan, said that at first he feared there could be vaccinia epidemics in hospitals. But after studying the medical literature, he concluded that he had overestimated the threat and that medical workers could be vaccinated without endangering patients as long as the workers followed instructions like keeping the vaccination site covered and washing their hands often. When he searched medical journals going back to the early 1900's, Dr. Sepkowitz said, "I think the key feature to me, looking back at these articles, is the paucity of outbreaks." Dr. Sepkowitz said he thought hospital outbreaks would be far less likely today because patients with rashes are routinely isolated, and there is more emphasis on hand washing and covering vaccination sites. The same goes with the home environment. With good hand washing and careful coverage of the site, it shouldn't pose a danger to normal children at home. posted by Sydney on 12/22/2002 11:22:00 AM 0 comments 0 Comments: |
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