It was a difficult decision for Andrea Deerheart Cornitcher, but she wanted to help.
So the registered nurse sidestepped her American Indian ancestors' thorny history with smallpox - a disease that some say was deliberately spread to them in Colonial times through infected blankets - and on March 18 was vaccinated for the disease.
Five days later, the 55-year-old Princess Anne resident died of a heart attack. She was the first of three people to have a fatal heart attack after getting the smallpox vaccine through the government's program of voluntary inoculations for health care and emergency workers who would respond to a bioterrorism attack.
Her husband, Standing Bear Mayo, wondering what went wrong, urged health care workers yesterday to avoid the vaccine.
"It was a hard decision [for her] because it was smallpox and it had been used as a weapon against Native Americans since the 1700s," said Mayo, also 55. "It was a sore spot in our heritage, but she put that aside. Her motivation was her caring."
Mayo and his wife of nearly four years had discussed how American Indians knew what "germ warfare" was before there even was such a term.
In the days before her death, Mayo said, the couple discussed historical accounts of how in 1763 the British occupying Fort Pitt (in what is now Pittsburgh) gave Indians blankets from a hospital filled with smallpox patients.
Cornitcher was a nurse at Peninsula Regional Medical Center in Salisbury and was vaccinated by the Wicomico County Health Department. She had a heart attack and died at a friend's home in Arlington, Va.
The evening before her death, Cornitcher, who was hypoglycemic, experienced vomiting and diarrhea and had collapsed in the Arlington home, but friends thought it was food poisoning or perhaps the result of low blood sugar.
Her friends found her asleep at 3:30 that Sunday morning, but about 9 a.m. discovered she had died.
An autopsy revealed a blood clot in one of the chambers of her heart and plaque in the arteries, said Mayo, a machinist.
"Her symptoms don't point to a simple heart attack," he maintained.
Cornitcher, an Assateague Indian who grew up in Philadelphia, had planned to move with Mayo to a Navajo reservation in New Mexico in August and incorporate Native American healing traditions with modern medicine.
The vaccine, which is made from a live virus related to smallpox, has been known to produce potentially serious complications in a very small number of those inoculated. But heart problems have not been among them.
The Centers for Disease Control and Prevention in Atlanta began investigating a potential link last week after receiving several reports of heart problems, including Cornitcher's fatal heart attack.
The others who died of heart attacks after receiving the vaccine were a 57-year-old nurse's aide from Florida and a 55-year-old National Guardsman.
Experts doubt link
Another Maryland woman, who has not been not identified, suffered a heart attack after being vaccinated, but officials said last week she had recovered. Other problems reported to the CDC included chest pain and heart inflammation.
All four had risk factors for heart disease, which include obesity, high blood pressure and a history of smoking, according to the CDC.
Experts have said they doubt there is a connection between the vaccine and the heart problems, but the CDC chose to err on the side of caution until it can definitively rule it out.
As a result, state and local health departments have been asked to vaccinate health workers under new guidelines - screening out people with known coronary disease or those with at least three risk factors for it.
Even so, several states have temporarily suspended vaccination programs out of safety concerns. The University of Maryland Medical Center also put on hold its planned inoculation of 40 workers.
The Associated Press contributed to this article.