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US health care workers spurn Bush smallpox vaccination plan
By Patrick Martin
1 March 2003
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The vast majority of the health care workers who were to be
inoculated against smallpox over the past month, under plans linked
to the Bush administrations preparations for war with Iraq,
have declined the vaccine. By February 24, one month into the
program, just over 7,300 volunteers have been inoculated, compared
to projections by federal officials of 450,000 to 500,000.
There is growing and increasingly vocal opposition to the vaccination
plan, despite the attempts of the White House and the Department
of Health and Human Services to manufacture a crisis atmosphere
over the supposed threat of a germ warfare attack from Iraq or
Al Qaeda. Some criticism focuses on the administrations
refusal to provide compensation for those who suffer from the
well-known side effects of the vaccine.
More fundamental, however, is the widespread suspicion that
the threat of smallpox has been deliberately exaggerated by the
administration to scare the public and win support for its policy
of war against Iraq. With the United States on the brink of war,
the mass rejection of smallpox vaccination by health care workers
is tantamount to a vote of no confidence. It gives a far truer
indication of the popular attitude towards the governments
war plans than those opinion polls which claim majority support
for bombing and invading Iraq.
The administration has presented no evidence that Iraq possesses
the smallpox virus, let alone the ability to use it as a weapon
against the American people. Smallpox is the only communicable
disease to have been completely eradicated on a worldwide scale,
through aggressive public health and vaccination programs in the
post-World War II period. The last case internationally was reported
in 1978, the last case in the US dates back more than 50 years.
Two laboratoriesthe federal Centers for Disease Control
in Atlanta, and a Russian government facility in Siberiaare
the only remaining repositories of the virus.
It is a historical fact that only one country is known to have
seriously considered the use of smallpox as a weapon of war in
the twentieth centurythe United States, which contemplated
using it in Vietnam. The US Army considered sowing smallpox on
the Ho Chi Minh Trail in 1966, but eventually discarded the idea.
(There is also the sordid history of the selling of smallpox-infected
blankets to Indian tribes in colonial America, a primitive form
of germ warfare. European colonists were immune from the disease
because of childhood exposure, but native Americans were not.
Many tribes were entirely wiped out in this way.)
A politically motivated campaign
The Bush administrations sudden shift on smallpox inoculation
underscores that the campaign is politically motivated. As recently
as last Junemore than nine months after the September 11
terrorist attacksfederal health authorities disclaimed any
intention of pushing for mass inoculations. An advisory panel
proposed at that time to limit inoculations to 20,000 medical
personnel who were most likely to come into contact with victims
of the disease.
In October, however, in conjunction with the Bush administrations
drive to win authorization from Congress for war with Iraq, federal
health officials reversed themselves and proposed a much wider
program, beginning with 500,000 health care workers, expanding
to 10 million emergency responders (police, fire, rescue) and
then the bulk of the American population as early as 2004.
This would entail colossal risks from side effects of the vaccine.
Published estimates have put the number of deaths arising from
the vaccination of 200 million Americans at between 200 and 482more
than in any terrorist attack except September 11 itselfwith
3,000 people suffering life-threatening complications, and 160,000
suffering serious side effects, ranging from blindness in one
or both eyes to skin conditions so severe they would amount to
disfigurement.
Even these numbers are likely gross underestimates, because
of significant changes both in the supply of vaccine and in the
underlying health of the American people. Much of the vaccine
being administered now is the frozen leftover of vaccines used
in the mass inoculation campaigns of the 1950s and 1960s. Whether
the vaccine will have the same effectiveness or carry the same
risks as 40 years ago is unknown.
The smallpox vaccine has particularly devastating effects on
those who suffer from preexisting skin conditions like eczema,
or from immune deficiencies, either from diseases like HIV/AIDS,
lupus and rheumatoid arthritis, or as a byproduct of chemotherapy
and drug treatment for cancer or organ transplants. Immuno-deficient
patients exposed to the vaccine can contract a condition called
progressive vaccinia, in which the sore normally produced by vaccination
grows uncontrollably, causing systemic infection. There is no
cure for progressive vaccinia and the death rate, 36 percent,
is comparable to that of smallpox itself.
The number of such potential victims of the vaccine is in the
tens of millions today, because of the spread of HIV and the advances
in cancer treatment and organ transplant techniques. Any vaccination
program would have to locate these individuals and exclude them
from inoculationa task fraught with difficulties ranging
from privacy concerns to simple ignorance and human error.
There is also great concern in the medical community because
inoculated health care workers frequently come into contact with
immuno-compromised individuals in the course of their daily work.
They can become a source of infection because the smallpox vaccine
is based on a live virus.
The Bush administration has carried out mass inoculations rapidly
in the armed forces, with more than 100,000 military personnel
receiving the vaccine with only a handful of reported serious
complications and no deaths. Far different results could be expected
when the program shifts from a group selected for youth and good
health to the general population.
There have been two dozen cases of serious complications from
the first inoculations among health care workers, but only fragmentary
reports are as yet available. Federal health officials announced
February 27 that three serious adverse reactions had been observed
in Florida alone, including one case of generalized vaccinia that
could lead to permanent scarring.
Immunity for drug companies
The Bush administration clearly anticipated a significant toll
from the side effects of the vaccine. Only days after the announcement
of the vaccination plan, congressional Republicans slipped new
language into the bill establishing the Department of Homeland
Security providing immunity from liability for drug companies
that manufacture the vaccine and for hospitals and doctors who
administer it. At the same time, the administration rejected calls
to establish a fund to compensate those who suffered severe side
effects from receiving the vaccine.
This grotesque double standardone law for giant corporations
and another for ordinary peopleis characteristic of the
administrations policies in virtually every sphere. There
were soon protests, however, from organizations representing health
care workers who were to be the first guinea pigs for the mass
vaccination plan.
The Service Employees International Union and the American
Federation of State, County and Municipal Employees urged their
members not to be vaccinated. The American Nurses Association
expressed reservations, and numerous state branches, including
California, Texas, Massachusetts, Rhode Island and Connecticut,
urged nurses not to participate.
Hundreds of hospitals have refused to inoculate their employees,
mainly because of concerns over possible secondary infections
for immune-deficient patients. Two state governmentsMichigan
and Arizonaand the New York City Health Department have
all declined to begin vaccinations until a compensation program
is put into place for those suffering side effects.
Spokesmen for the medical community have criticized the administration
for pouring tens of millions of dollars into a nonexistent crisis
while ignoring genuine health care needs. Dr. Paul Offitt of Childrens
Hospital in Philadelphia, the only member of Bush administrations
advisory panel to vote against the vaccination plan, said, Flu
will kill 20,000 people this year, mostly less than four years
oldand we have a vaccine. Its too bad that Saddam
Husseins not behind influenza. Wed be doing a better
job.
The credibility of the Bush administrations warnings
of impending attack is also being questioned. Dr. William Schaffner,
chairman of preventive medicine at Vanderbilt University Medical
Center in Nashville, Tennessee, told the Washington Post,
It is not enough for someonewhether it is the president
or the secretary of stateto say, Im worried
about this; trust me. We need more than that today as a
profession and as a society.
See Also:
The US terror alert
Washington employs fear and panic as instruments of war
[14 February 2003]
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