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Top U.S. Health Official Says “Vast Majority” of States Ready for Smallpox By David McGlinchey Government Executive WASHINGTON — U.S. Health and Human Services Secretary Tommy Thompson said yesterday that the “vast majority” of states are now prepared to immunize all their residents in 10 days if there were a smallpox bioterrorism attack (see GSN, Jan. 29). Julie Gerberding, director of the Centers for Disease Control and Prevention, set the 10-day immunization goal as a measure of preparedness. Thompson’s comments represent perhaps the most optimistic assessment to date of the nation’s ability to withstand a smallpox attack (see GSN, Dec. 12, 2003). Thompson, however, did not offer any evidence to support his claim, and he made his assertion despite a faltering smallpox immunization program. When President George W. Bush announced the campaign in December 2002, health officials said that they wanted to immunize hundreds of thousands — if not millions — of health care and emergency workers within a year. Those immunized workers would then vaccinate the general population in the event of an attack. More than a year later, however, fewer than 40,000 civilian emergency workers have received the vaccine. Yale University professor Edward Kaplan, a vocal critic of the CDC’s smallpox vaccination plans, estimated last year that a 10-day national immunization effort would require 1.25 million prevaccinated health care workers (see GSN, Jan. 10, 2003). Thompson said yesterday that the immunization program “certainly is stalled right now,” but health officials are “pushing hard to get more people vaccinated.” He said also that the 40,000 immunized emergency workers are “not as many as we would like.” Thompson’s claim that most states are prepared for a smallpox attack is based on plans produced by those state governments, according to a CDC spokesman. Every state has developed a bioterrorism response plan and “their response plans indicate that they can vaccinate,” said CDC spokesman Von Roebuck. “A good number of states have exercised their plans.” The CDC, which heads up smallpox preparedness efforts and the immunization program, does not yet have a mechanism to measure a state’s ability to respond to an attack. A CDC official told Government Executive last week that health officials are currently developing “federal standards-based exercise scenarios” to test regional smallpox defenses and bioterrorism preparations by late 2004 (see GSN, Jan. 26). CDC Associate Director for Terrorism Preparedness and Response Joseph Henderson said also that states must test their plans to be sure that they truly are prepared for an attack and can meet the 10-day goal. Democrats from the House Select Committee on Homeland Security released a report yesterday criticizing the smallpox immunization effort and alleging that the stalled efforts have left “much of the nation vulnerable to a smallpox attack.” The report accused federal health officials of poor management and leadership and said the government had not provided enough resources to the immunization campaign. David Schanzer, the minority staff director for the committee, said there is no evidence to support Thompson’s comments. “The clear facts set out in our report don’t support that conclusion,” Schanzer said. He also said that CDC officials never explained why they shifted their goal from about 500,000 immunized personnel to the ability to immunize in 10 days: “They clearly haven’t met the standard that they set for themselves one year ago, and haven’t articulated what has changed over the course of the year that would justify so dramatically lowering the bar.”
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