Health-care workers roll up their sleeves

POPLAR BLUFF, Mo. -- As his shoulder was jabbed 18 times in rapid-fire succession with a small needle, Dr. Michael Stevenson winced and gingerly looked away from the nurse who was sticking him.

"It hurts, but it's not intolerable," said Stevenson, a doctor who works as the medical consultant at the Butler County Health Department. "If it's got to be, it's got to be."

And it does have to be, at least according to Stevenson and other Southeast Missouri doctors and nurses who were given the smallpox vaccine Friday as part of a governmental program to protect the United States against a biological attack.

Stevenson was stuck 15 times because he had the smallpox shot previously while in the military and three more times because his shoulder didn't bleed. That's to make sure the vaccine --a live smallpox-related virus -- gets into the system. Those who have never had the smallpox vaccine only had to be stuck three times.

"But we have to do it," Stevenson said. "Who's going to take care of people if smallpox comes back?"

Fewer than 20 health-care workers -- exact numbers were not provided -- were voluntarily given the shot Friday at the Butler County Health Department in Poplar Bluff. About 100 health-care workers were given the shot in Missouri, including at sites in St. Louis, Kansas City, Columbia and Springfield.

In Poplar Bluff, a security guard stood in a hallway next to the room where the shots were given as a precaution against unwanted intrusions.

"We wanted security in case someone wanted to stop us from doing this," said Robert Hudson, director of the Butler County Health Department.

Four of those nurses and a doctor were from the Cape Girardeau County Public Health Center. Workers from Stoddard and Butler counties also participated.

"I'm almost exhausted," said Charlotte Craig, the center's director who was also inoculated Friday. "It's not an easy thing to go through."

Craig said they had scheduled five nurses to get the vaccine, but one nurse was screened out because she was recovering from the flu. Otherwise, she said things went "beautifully."

No pain

Craig said her shot didn't hurt.

"If there had not been so much verbalization about this -- all the bad things that can happen -- I don't think any of us would have had second thoughts," she said.

As it was, they did have second thoughts.

"Sure, we did," she said. "I'm a nurse, and nurses are your worst patients."

Those second thoughts, however fleeting, were because of side effects that make one in 1,000 seriously ill and kill one in 1 million. Most people experience normal, usually mild, reactions that include a sore arm, fever and body aches.

However, other people can experience serious to life-threatening reactions. The vaccine being used can cause brain damage or even death in a small percentage of those inoculated, usually children and people with weak immune systems. Those side effects have even convinced some health-care workers in other states not to be vaccinated.

"I guess I can see their point," said Sherri Harper, a registered nurse who lives in Dexter, Mo., but works at the Butler County Health Department. "But I see it as a patriotic thing. I'm doing it for my country. People are going to be relying on us to take care of them should something happen."

The government's plan includes inoculating half a million military personnel as well as an estimated 450,000 nurses and doctors. Nurses, security officers, dermatologists and housekeeping staff at Cape Girardeau hospitals will eventually receive vaccinations in the coordinated effort to minimize an outbreak of smallpox, which kills about 30 percent of its victims and scars the remainder for life.

A natural case of smallpox hasn't been reported in the world since 1977. The last U.S. case was in 1949, and routine shots were stopped in 1972. Experts fear the potentially fatal infectious disease could be released again in an act of bioterrorism.

The vaccination is expected to be made available to the public by January 2004.

smoyers@semissourian.com

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