As far as vaccines go, today’s focus is on the influenza vaccine, or the lack of. But whatever happened to the smallpox vaccine, that ill-fated venture that has quietly slipped into the past, and hasn’t been heard from since.

I mean, weren’t we on the verge of a bioterrorist attack? Didn’t some loony have their hands on a vial of smallpox virus, and was about to unleash it on millions of unsuspecting innocents? And wasn’t that the reason for the government spending about $800 million to get this vaccine rolling, which included relieving the pharm company of any liability?

Not Without A Risk, My Dear

The smallpox vaccine is a live vaccine, which means that after receiving an injection, you can possibly infect other people from the scab that forms over the injection point. There is a rather high probability of adverse reactions, so you would most probably lose a few days of work because of it. If you had a severe reaction, you may be laid up for a much longer period of time. Perhaps for good.

About one million American with weakened immune systems, or a history of skin conditions, faced a much higher risk and in fact, were advised against the vaccine. Because of this risk, anyone who would want the vaccine would need to be screened.

Between 1 in 4,000 to 1 in 10,000 healthy people, who receive the small pox vaccine, experience side effects that are severe enough to require treatment with a product called vaccinia immune globulin. This is made from blood taken from individuals who have been vaccinated with the live vaccinia virus.

Estimates were that of healthy vaccine recipients, one to two, per million, would die. The risk for serious conditions such as encephalitis, progressive vaccinia and eczema vaccinatum, was estimated at about fifteen per million people.

Now, those numbers don’t sound like a great many people would drop dead, or suffer from severe reactions but…why on earth should even one person die, in order to receive a vaccine against a disease which has been eradicated for over 20 years???? And when the “evidence” that an attack is imminent, is vague at best?

First Responders

The Bush administration’s plan was for half a million health care workers to receive the vaccine. They were stunned when the expected response just didn’t happen. For one thing, there was no evidence that we were going to be attacked with a bioengineered version of smallpox (and then you’d have to wonder if the vaccine would work, in the case of an altered virus).

Second, relatively no money was given to local communities and hospitals to implement this. Screening programs would have to be set up, in order to make sure that no one at risk received the vaccine. Nurses would also have to be trained in how to even give the vaccine, since it is quite different from other types of injectibles. Many employees would need sick days because of adverse reactions. Nurses, doctors, and other workers who are in contact with immunosuppressed patientst and/or those with skin diseases, could not go near that population until their scab healed. Plus, the pharm company making the vaccine was granted immunity against liability. So who was going to bail out the poor nurse who contracted encephalitis as a result of the vaccine? Or had to miss several weeks of work?

The Dept of Health and Human Resources was forced to take this back to the drawing board, and come up with some kind of compensation plan. When they finally did rustle up a compensation plan, you really didn’t know whether to laugh or cry. It was basically an insult to each and every healthcare worker, and once again, shows the “high regard” in which healthcare workers are held. Their pathetic little proposal, which was blasted by just about every related workers union and professional organization, decided that it would pay $262,100 for workers who die or suffer permanent and total disability as a result of a smallpox shot. Wow. Your life for $260,000, and considering that you took this vaccine simply because the government decided that you should. And if you’re permanently disabled, how long will that money last?

The most insulting was that the plan also said it would pay people two-thirds of their lost wages after their fifth missed day of work, up to $50,000. Isn’t that nice of them. So you get no money for days 1-5, and then only two thirds after that. And since most reactions would only cause less than five days of missed work, the government gets off free and clear, while the poor nurse gets no pay.

Oh, and they would also cover medical expenses for major reactions to the vaccine, to the extent that those weren’t covered by health insurance. What about minor reactions? And who decides if its major? The list of “reactions” to be covered was never published.

And most important, no one could exactly say what the threat was, or what the exact risk was. Or who it would be coming from. Or why we were suddenly at risk for smallpox.

Many hospitals refused to have anything to do with it. Public health authorities in many states pointed out that they needed their money to deal with, uh, real diseases. You know, stuff like TB, AIDS, sexually transmitted diseases, and other public health problems like drug addiction, alcohol abuse, pregnant teenagers, and so on. Since they weren’t getting any money to implement this grand smallpox scheme, they really couldn’t afford to waste valuable resources on this nonsense.

A Monumental Failure

I suppose that the Bush administration expected that the half million “first responders” would be bitten by some blind patriotic fervor, and rush up to the plate to get vaccinated by a potentially lethal vaccine. They would be good and obedient soldiers, not ask questions, and be willing to accept any consequences.

But that isn’t what happened. The plan was rolled out in December 2002, and by August 2003, less than a tenth of the planned number had been vaccinated. A report from the US Institute of Medicine, criticized the plan and pointed out that a collossal waste of time and money had been put into this. Instead, they argued, why weren’t we developing a real plan for a bioterrorist attack? The time and money might have been spent on more important defensive measures such as disease surveillance and response plans.

The first phase, as it was known, quietly came to an end.

Phase two, in which the vaccine was to be offered to millions more healthcare workers and the public, was put to bed by the CDC with little fanfare. Reports were now pouring in about how recently vaccinated soldiers and civilians had developed serious complications, including 52 cases of pericardial or heart inflammation, 8 heart attacks with three fatalities. And for what? To protect against a phantom disease?

So back to my original question. Surely if we were really in danger of a smallpox attack, the idea of vaccinating the public would not have been put to rest so quickly. So what was this really about?

Acambis, a European vaccine manufacturer, was paid $771 million to develop 209 million doses of smallpox vaccine by the end of 2002. Just think if that money had been spent on real biodefense, on a real program. We might be prepared now for an emergency, instead of being sitting ducks. But hey, we’ve got 200 million doses of smallpox vaccine.

Image: Courtesy of Geekphilosopher.com