8 `first responders' get smallpox shots at clinic

300 officers, firefighters, paramedics are invited

8 `first responders' get smallpox shots

Carroll County

October 01, 2003|By Mary Gail Hare | Mary Gail Hare,SUN STAFF

The Carroll County Health Department invited more than 300 police officers, firefighters and paramedics to be inoculated against smallpox yesterday. By last night, eight "first responders" had gone to the clinic, the first of its kind in the state.

The turnout did not surprise Carroll County health officer Larry L. Leitch, who said that emergency workers apparently were fearful of the vaccine's side effects.

"People overestimate the probability of getting sick" from the vaccine, said Leitch, who, with 12 other members of a team that would orchestrate immunizations in the county in the event of an outbreak, was inoculated against smallpox this year.

The state oversaw the vaccination of similar teams throughout Maryland this year. The clinic in Westminster was the first in what is to be the next step in the statewide effort, turning attention to emergency workers, said Richard Stringer, deputy director of community health for the state Department of Health and Mental Hygiene.

"Carroll is the first county to hold a clinic, but the others are gearing up to run clinics in the near future," Stringer said. He did not want to comment on yesterday's turnout.

In December, when President Bush announced a plan to vaccinate health care workers and emergency personnel to guard against terrorist attacks, officials spoke of vaccinating as many as 500,000 civilians.

But far fewer people than expected have turned up for the voluntary immunizations, and only about 38,000 people had received the vaccination by mid-August, according to the national Centers for Disease Control and Prevention.

That was when a panel of doctors assembled by the Institute of Medicine, noting the small risk of severe or fatal side effects, advised the government not to rush to vaccinate large numbers of people.

When Leitch and other members of his staff were inoculated in March, he said he expected about 100 doctors and nurses at Carroll County General Hospital to be inoculated. But they have not, said Dr. William Woodward, an epidemiologist with the Carroll Health Department.

Leitch is trying to build a team that would orchestrate a vast and immediate immunization program for Carroll's nearly 160,000 residents. Plans call for setting up six vaccination clinics at schools throughout the county in the event of an outbreak.

Emergency workers in Carroll County were notified by e-mail of the inoculation clinic, and Leitch visited the county Sheriff's Department.

Bruce Fleming, chief of Sykesville-Freedom District Fire Department, was among those who declined to participate.

"It sounds like they're not sure it will protect you, and you're going to have to get it again if you get exposed to it," he said. "What's the point of that? I just don't see it's a big advantage at this point."

First Sgt. James Meyers of the state police barracks in Westminster said that he saw the notice, but that he had no intention of responding unless an order came down from his chain of command.

"If it is needed they'll tell us about it," Meyers said.

The first person to arrive at the Carroll County's smallpox vaccination clinic was surrounded by about 10 health-care workers yesterday morning.

"What a big hoopla," said Carlos Bustos, 28, an undercover officer with the Sheriff's Department. "I guess I am the first victim."

For the next hour at the Health Department in Westminster, Bustos read through a hefty information packet, watched a brief video on the vaccine narrated by Dr. Julie L. Gerberding, director of the Centers for Disease Control - he asked for popcorn - and sat through lengthy interviews with nursing teams.

The staff repeatedly assured him that he could change his mind at any time during the process and warned that if he had any of the risk factors such as a weakened immune system or HIV, they would not inoculate him.

"The decision is yours to make," Gerberding said on the video. "Be honest with yourself about your risk. If there is any doubt, don't proceed."

After receiving the vaccine, the sheriff's deputy had another interview with the emergency response coordinator who told him how to care for the vaccine site on his left arm and what he could expect during the next few days.

"I am not worried about a reaction," Bustos said. As for the shot itself, he said, "It was just like somebody poking you in the arm."

Woodward, the Health Department epidemiologist, said Bustos likely had received the first smallpox vaccine given in Carroll County since 1972.

"We are witnessing history," he said.

The doctor was probably the only person at the clinic who had seen a case of smallpox, a contagious disease that killed nearly 300 million people worldwide in the 20th century.

In the 1960s, Woodward was working for the CDC in Bangladesh on a cholera outbreak when he encountered a smallpox patient.

The last known case of smallpox was diagnosed in Somalia in 1977, and the World Health Organization declared the disease eradicated in 1980.

The vaccine used yesterday in Westminster has been freeze-dried in storage for decades at the CDC repository in Lancaster, Pa. At the clinic, it was reconstituted with saline.

By 7 p.m., seven others besides Bustos had been vaccinated.

Among those was Westminster Mayor Kevin E. Dayhoff, a volunteer with the city Fire Department and the Red Cross.

"If we were to have an incident involving public safety I would want to be one of the first responders," he said.

Smallpox has no cure and no treatment other than routine nursing care. Those who were vaccinated in childhood should not consider themselves immune to the virus, Leitch said.

Sun staff writers Athima Chansanchai and Scott Shane contributed to this article.

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