Preevent Smallpox Vaccine

For people with high-risk exposure to smallpox, there are no contraindications to the vaccine, because persons at greatest risk from vaccine complications are also at greatest risk for mortality from the disease (32). However, for preevent vaccination purposes, in the absence of circulating smallpox disease, the following groups of people should not receive smallpox vaccine (32) ... 

However, because of the possibility of a smallpox attack, albeit remote, in December 2002 President Bush announced his preevent vaccination plan. Instead of mass vaccination, the plan, based on recommendations from the CDC, the Advisory Committee on Immunization Practices (ACIP) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) makes smallpox vaccination available for people designated by public health authorities to conduct investigation and follow-up of initial... 

Some hospitals chose not to participate in the preevent smallpox vaccination program. Others have chosen to participate, but have sent fewer of their staff for... 

Although Section 304 satisfied some of the liability concerns, it failed to address health care worker worries about compensation for lost wages due to side effects of the vaccine (27). In addition. Section 304 did not address hospital and health care worker concerns about whether compensation would be adequate for victims of vaccine complications, including victims, such as household contacts, who were not vaccine recipients. Consequently, on April 30, 2003, the President signed a law to compensate health care workers or first responders injured by the preevent smallpox vaccination program. The law established a no-fault fund that had the following provisions (35) ... 

Hospital administrators felt that the risk and costs associated with a preevent vaccination program outweighed the risk of a smallpox attack. Even if an outbreak were to occur, given the effectiveness of the vaccine for 3 days after exposure, hospital administrators felt rapid mass vaccination efforts and quarantine of exposed individuals would probably be effective in connolhng the spread of the disease. 

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