Communicable Diseases
|
Other Information On Communicable Disease |
|
 |
West
Nile Virus Fact Sheet |
|
Communicable Disease Reports for Randolph County |
|
Important Information for You and Your Family |
|
Press Releases Regarding Communicable Disease |
|
Facts About Smallpox |
Return to Environmental
Health Services
Home Page
Smallpox
Vaccine - Frequently Asked Questions
When was smallpox eradicated?
Routine smallpox vaccination was stopped in the United States in 1971.
Smallpox was eradicated in 1980 and the last known case in the United
States was in an immigrant in 1978.
Why is it a threat now?
Smallpox virus has been researched and developed as an experimental
biological agent of mass destruction by several countries. Some countries
or groups may still have stores of smallpox virus and may deliberately
release the virus as an act of war.
Are those who were immunized
for smallpox prior to 1971 protected?
Although, some immunity may be present for persons immunized previously,
we cannot answer with any certainty how protected a person might be from
a vaccine administered over thirty years ago.
Can the public health system
really mass vaccinate thousands of people?
Yes, with the help of the private medical sector, volunteers, fire, police
and the State Emergency Management Agency (SEMA) we can obtain adequate
amounts of vaccine within 12 hours, set up dispensing sites and fully
vaccinate thousands of people within the necessary four-day time period.
If one or more cases of smallpox were identified, an immediate surveillance
and containment strategy would be instituted. It would include identification
of infected persons through intensive surveillance and isolation of infected
persons. It would also include ring vaccination, i.e., vaccination of
household contacts and other close contacts of infected persons (i.e.,
primary contacts), and vaccination of household and other potential contacts
of the primary contacts (i.e., secondary contacts). In addition, depending
on the specific circumstances, vaccination of a larger population of persons
might also be undertaken. The recently released "Smallpox Vaccination
Clinic Guide" from CDC is a very useful tool in helping us prepare
in advance for situations in which vaccination of large numbers of persons
is necessary.
How soon after I have been exposed
can I still be vaccinated and be protected?
Receiving smallpox vaccine within 4 days of exposure to smallpox will
decrease your chances of becoming sick, or of developing serious (perhaps
fatal) illness.
Why not vaccinate the entire
population now?
Smallpox vaccine is a live-virus vaccine which contains vaccinia (not
smallpox) virus, and which does have severe and life-threatening side
effects for some people. CDC estimates that 1 person in 10,000 who receives
the vaccine will have serious side effects that require a doctor's care.
Also, if the vaccine were to be given to everyone in the United States,
it is estimated that 350 to 500 people would die from the vaccine. That
is about 1 or 2 deaths for each million doses of smallpox vaccine administered.
Certain people should not receive the vaccine (unless they have actually been exposed to the virus). These include: pregnant women; people with certain skin conditions - especially eczema; and people with weakened immune systems, such as those who have received a transplant, are HIV-positive, or are receiving treatment for cancer.
So what is the difference between
today and the vaccination programs we used to have?
Recommendations for the use of smallpox vaccine, both in the past as well
as today, take into account the risk of smallpox disease versus the risk
of complications from the vaccine. When smallpox was seen as a substantial
threat to the population, vaccination was recommended. However, by the
early 1970's it was judged that the risk of vaccine complications outweighed
the threat of endemic smallpox, and routine childhood smallpox vaccination
was discontinued in the United States in 1971. Routine vaccination of
health care workers ended in 1976, and among military recruits in 1990.
In recent years, with no confirmed cases of smallpox occurring, and the
risk of a bioterrorist attack assessed as low, vaccination of the general
population was not recommended because the potential benefits of vaccination
were not seen to outweigh the risks of vaccine complications. Today, with
continued reports of possible future use of smallpox virus by bioterrorists
(and with the increased availability of smallpox vaccine), the Federal
government is in the process of developing guidelines for the pre-event
(i.e., before a case(s) of smallpox is diagnosed) use of the vaccine.
At this point in time, which groups of people will be recommended to receive
the vaccine remains unclear.
Also, the following points need to be kept in mind when considering our present situation:
First, we have many more immunocompromised individuals, such as chemotherapy patients, organ transplant recipients, and HIV-infected persons. These individuals would be at increased risk for serious adverse reactions following smallpox vaccination.
Secondly, as mentioned above, smallpox vaccine is a live-virus vaccine which contains vaccinia (not smallpox) virus. Vaccinia virus is present in the sore that develops at the site of the vaccination, and can be transmitted through direct contact (e.g., contaminated hands) to others. This appears to be a generally rare occurrence, but can potentially result in serious illness in some persons who are contacts of smallpox vaccines (particularly persons who have certain skin conditions or are immunocompromised). Because of these concerns, when smallpox vaccine is given in non-emergency situations, persons whose household contacts have active eczema, or whose household contacts have a history of eczema, should not be vaccinated. Also, persons should not be vaccinated in non-emergency situations if they have household contacts with certain conditions that result in a weakened immune system (e.g., certain malignancies, certain medications, organ transplants, HIV infection), or if they have household contacts who are pregnant or who have certain other skin conditions in addition to eczema.
Finally, if exposed to an actual case of smallpox the risk of contracting
smallpox is much greater than the risk of severe side effects from the
vaccine. However, in a non-emergency vaccination situation, even one case
of severe vaccine side effects will most likely be widely publicized and
result in the public's reluctance to be vaccinated should an actual case
of smallpox appear.
If I have been exposed to a smallpox
case, why should I get the vaccine, which can have serious side effects?
If you have been exposed to an actual case of smallpox, the risk of smallpox
infection and the development of serious disease are much greater than
the risk of severe side effects from the vaccine.
Will I be forced to take the
vaccine, even if I have been exposed?
No, if you are exposed to a case of smallpox, and you decide not to take
the vaccine you will be closely monitored for 18 days for the signs and
symptoms of smallpox. Those members of your household who cannot, because
of medical conditions, or who decide not to be vaccinated will need to
move, elsewhere, for that 18 day period of time. You will be allowed to
leave your home, but not travel more than one hour away, in case you begin
to show signs and symptoms.
Who will pay for mass vaccination?
The Federal Government will provide the vaccine. Distribution and dispensing
costs associated with a mass vaccination program will be borne by the
state and local governments.
How will we recruit volunteers?
The State and Local governments are developing plans for working with
agencies such as the Red Cross who are experts in volunteer management
and with professional associations such as pharmacists, physicians and
nurses to develop lists of potential volunteers.
How will we train volunteers,
such as nurses to administer the shots?
State and local plans will include working with current volunteer organizations
such as the Red Cross as well as experts in CDC to provide necessary training.
Local jurisdictions will be conducting drills to provide volunteer training
opportunities as well.
What is one of the most important
things state and local public health agencies can do at this time?
We need to educate and inform the public so that they can participate
in their own defense in the event of a biological, chemical or nuclear
attack. Understanding who public health is and how public health works
to protect citizens is an essential component of an individual's or family's
ability to prepare for the event and to follow the recommendations of
the Centers for Disease Control and Prevention, Missouri Department of
Health and Senior Services and the local public health agency.
Whom should I contact if I want
to volunteer?
Contact a local emergency response volunteer organization in your area
such as the Red Cross or your local fire department, or contact your professional
association or licensing board.
DHSS web site: www.dhss.state.mo.us; DHSS toll free number for emergencies and disease reporting 800-392-0272, available 24 hours a day, 7 days a week; your local public health agency.
If you have any questions or need additional information please contact us. We'll be glad to help.