Most U.S. states have submitted smallpox vaccination plans to federal officials by this week’s deadline, the Associated Press reported today.

State’s vaccine requests vary greatly, from Georgia’s plans to inoculate up to 500 people to California’s request for 70,000 doses of the vaccine, AP reported.  Strategies on vaccination are also greatly varied.  Michigan, for example, has requested 5,000 to 7,000 doses to offer at roughly 30 hospitals.

“We don’t necessarily need it in every corner or at every hospital,” said Geralyn Lasher of the Michigan Department of Community Health.

North Dakota, however, plans to have at least 15 immunized workers at each of its 46 hospitals.

“We really believe that it’s likely that smallpox patients could present themselves at any of our hospitals,” said Tim Wiedrich, biological terrorism coordinator for the North Dakota Health Department.

The widespread nature of the requests was expected, according to at least one U.S. health official.

“We wanted to give them that flexibility,” said Jerome Hauer, the chief biological terrorism official at the U.S. Department of Health and Human Services.

U.S. officials plan to begin a public education campaign on the smallpox vaccine to coincide with the immunizations, which would begin after the Bush administration issues orders to state officials.  Once vaccinations are underway, states would be required to carefully monitor reactions and report twice a week to the Centers for Disease Control and Prevention.

Officials have said that fewer than 500,000 people will probably receive the shots because not all of those selected will agree to be vaccinated, and some will have conditions that put them at risk of side effects.

The effort will be “one of the most complicated logistic activities any state and local agency will have to undergo,” said Michael Osterholm, a University of Minnesota bioterrorism expert (Laura Meckler, Associated Press, Dec. 10).

Meanwhile, Arizona and a several other states missed the Monday deadline to submit smallpox vaccination plans, according to the Associated Press (see GSN, Nov. 22).

Arizona health officials said they expect Governor Jane Hull to approve their plan this week.  U.S. officials would receive the plan thereafter, but a state official said that immunizations are not imminent.

“We will not be giving any smallpox vaccinations until liability and compensation issues are cleared up,” said David Engelthaler, bioterrorism coordinator for the Arizona Department of Health Services (see GSN, Nov. 15).

The state’s plan includes phased vaccinations over six weeks, allowing medical personnel to learn more about side effects (Associated Press, Dec. 10).

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