PENNSYLVANIA Smallpox inoculation begins

The program for health-care workers is voluntary, state health officials said.
HARRISBURG (AP) -- The state department of health inoculated five public-health workers against smallpox Monday to start a network of public-health and hospital workers who would vaccinate the public in a terrorist-triggered emergency.
The five workers in turn will be trained to give the vaccinations to others. Public-health officials hope to have a force of 120 people inoculated in four to six weeks, who will then vaccinate thousands of doctors and nurses statewide.
"This is a voluntary program," said Dr. Robert Muscalus, state physician general and acting health secretary. "Anyone who is being vaccinated has volunteered to do so."
If there is an actual outbreak of smallpox, the health department hopes to have the capacity to vaccinate 1.2 million Pennsylvanians in 10 days, said Michael K. Huff, director of the Bureau of Community Health Systems.
The risks
Smallpox has not been seen in the United States since 1949, and the disease was declared eradicated globally in 1980. But anti-terrorism officials worry that a new outbreak could result from a terrorist attack.
The vaccine is not without its risks. About one in three people who get the shot fall ill enough to miss a day of work. Historically, about 40 people out of every million vaccinated for the first time face life-threatening reactions, and one or two die.
The state's largest health-care union, District 1199P of the Service Employees International Union, is advising its members to say no to the vaccine until better safeguards are in place for health-care workers and patients.
"Health-care workers want to be ready to take care of patients in a real health emergency. But the smallpox vaccine itself poses a serious public-health risk," said Marilyn Hostetter, the union's nurse coordinator. "This plan falls short of the safeguards that must be in place to protect caregivers, their families, their patients and the public."
Dr. Muscalus said hospitals were still being surveyed about whether they wanted to participate in the program. Some have deferred a decision until later; others have embraced the program, he said.
As a result, state officials are not sure how long it will take to immunize the thousands of hospital workers the health department would like to have on hand in the event of an emergency.
The state ordered 22,500 vaccines from the federal government, a figure department spokeswoman Amy Kelchner recognized as high in light of some hospitals' reluctance to go along with the program.
The health department is hoping to begin training in hospitals by the first week of March, allowing vaccinations to begin two weeks later, Huff said.
"This is a voluntary program. If you only do one, then that's a success because that's somebody who will be ready to care for a smallpox patient if one should darken their door," Huff said.

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