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U.S. Smallpox Vaccination Program Hindered by Overburdened Health System, Study Finds
An overburdened public health system, low volunteer rates and liability issues have undermined the U.S. smallpox vaccination program, according to a new study in the Journal of Homeland Security (see GSN, Jan. 30). The researchers assert that the “probability of a smallpox bioterrorist event remains unknown, but the level of vulnerability of the United States population makes the threat too great to ignore.” Due to such concerns, the United States announced a multiphase smallpox preparedness program in late 2002 that included a first-stage goal of vaccinating 500,000 public health workers on a voluntary basis. However, the number of health care workers vaccinated since then, about 40,000, has fallen far short of the goal. The researchers, American Public Health Association Executive Director Georges Benjamin and others, conclude that the vaccination campaign “fell on a public health system bereft of infrastructure and resources.” One state official quoted in the study called the program, “an unfunded mandate eating the [state] money.” The researchers add, “Despite the best of efforts, the lack of specifically awarded smallpox vaccination funding was an impediment to the … program.” The study also finds that many potential volunteers chose not to receive the vaccine because of perceived health risks, implying that “states needed to address the risk-benefit analysis that potential volunteers were likely conducting on a personal level before deciding to be vaccinated.” The study concludes that the resulting “logistical, recruitment, and screening challenges … contributed to lower-than-anticipated numbers of vaccines.” In addition, the study concludes that concerns about liability issues kept potential vaccinees away. Because of a risk of side effects, including the low risk of death, “public health officials had early concerns regarding compensation and liability,” the study says (Journal of Homeland Security, February 2004).
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