Plan to vaccinate health workers against smallpox is faltering

WASHINGTON -- The number of health care workers vaccinated against smallpox varies widely across the country, a top federal health official said Thursday, offering the most detailed picture yet of the foundering vaccination program.

Nationally, only about 38,000 people have been vaccinated against the virus, which has been wiped from earth but could return in an act of bioterrorism. Federal official believe the nation needs a substantial core of vaccinated workers prepared to treat patients should an outbreak occur. But while some states have many hospitals with a substantial core of vaccinated workers, about a dozen have none.

"Some states and jurisdictions are doing quite well," Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, told a Senate committee Thursday. "Others are lagging behind."

It's far short of the initial target of vaccinating some 450,000 people nationally in a first stage of shots, including people on public health response teams and hospital workers.

Smallpox vaccinations, which carry rare but serious risks, have come to a virtual standstill amid doubts about the seriousness of the threat and resistance among health workers.

Sen. Edward Kennedy, D-Mass., expressed deep concern about the flagging program and about the nation's overall preparation against the bioterrorism threat.

"In one area where this administration has tried to take action -- smallpox vaccination -- the result has been a shambles," Kennedy said. "Instead of a coordinated plan ... the administration rushed forward with a poorly planned program of vaccination. The result is that the vaccination program is off course and behind schedule."

Kennedy also expressed dismay that, while Congress approved compensation for people injured by the vaccine nearly three months ago, the Bush administration has not published the table of injuries needed to implement the program. This table indicates how much money someone will receive for various types of injuries.

"We are increasingly concerned about the delay," Sens. Kennedy and Chris Dodd, D-Conn., wrote Thursday in a letter to Health and Human Services Secretary Tommy Thompson. "Too many first responders aware of the possibility of side effects are refusing to participate in this very high priority vaccination program."

Gerberding said the table was nearly complete and she expected it to be released soon.

She also said that while vaccinations are lagging behind expectations, federal and state authorities have done other work to prepare for the possibility of a smallpox attack. That includes ordering and receiving more vaccine doses, developing plans to distribute the vaccine in mass clinics should an attack occur and training doctors and others about the disease and how to spot and treat it.

Gerberding showed the Health, Education, Labor and Pensions Committee a U.S. map showing that vaccination clinics have operated in cities across the country. Many of these clinics have vaccinated only a handful of people, but they would be prepared to vaccinate others in the case of an attack, she said.

A second U.S. map showed just how spotty the coverage is now. Dots were placed on cities with at least one hospital that had vaccinated at least 25 workers. Close to a dozen states had no dots at all, including a swath of the country stretching from Montana to Idaho to Nevada to Arizona to New Mexico to Colorado. There were also no dots in Maine, Georgia, Oklahoma, Alaska or Hawaii.

A full list of all states without dots was not immediately available; borderlines on the map showed to the Senate committee were blurry in some cases, making it unclear which state claims the dot.

The CDC map gave bigger dots to cities with hospitals that had 50 or more vaccinated workers. And the largest dots were placed on cities with multiple hospitals with substantial vaccination.

Only about a dozen states had cities with the largest dots, although some of them, including Florida, Texas and Tennessee, had several cities with the largest dots.

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Centers for Disease Control and Prevention: www.cdc.gov/