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Smallpox Vaccination Update

Smallpox Vaccination Update. Nancy Fasano 2003 Michigan Communicable Disease Conference Fasanon@michigan.gov. The story in a few headlines…. Dec.13, 2002 : Smallpox: To vaccinate or not?

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Smallpox Vaccination Update

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  1. Smallpox Vaccination Update Nancy Fasano 2003 Michigan Communicable Disease Conference Fasanon@michigan.gov

  2. The story in a few headlines… • Dec.13, 2002: Smallpox: To vaccinate or not? • Dec. 16, 2002: The Smallpox Scenario-- Fears that Iraq may possess the virus have lately come to a head. What the U.S. is planning…

  3. And… • Dec 16, 2002:Half of second target group for smallpox shots may refuse them, officials estimate • February 24, 2003:Bush Smallpox Inoculation Plan Near Standstill Medical Professionals Cite Possible Side Effects, Uncertainty of Threat

  4. And… • April 11, 2003:Smallpox compensation deal reached • April 13, 2003:Officials: Smallpox plans squeezing services'It has forced trade-offs'

  5. And… • April 13, 2003: U.S. Smallpox Vaccine Program Lags “According to Health and Human Services Secretary Tommy G. Thompson, vaccinating one-fifth of the number of people originally proposed will indicate success at this point.”

  6. And finally… • April 29: Report Faults Federal Officials for Problems in Smallpox Program • May 1, 2003: Bush Signs Smallpox Vaccine Compensation Package, Allowing Affected People Up to $50,000 Per Year

  7. What we expected in December • 5,000-7,000 vaccinees in Michigan • Public Health Response Teams • Hospital-based health care response teams • A timely response from Congress to injury compensation issues • Vaccination beginning by mid to late January

  8. What really happened • The state vaccination clinic (ta-da!) on February 21, 2003

  9. Since February 21 • Fewer than 1,000 vaccinated to date statewide • Some regions began vaccinating immediately after February 21 • Other regions waited for resolution of compensation issue

  10. The Big Picture • 690 vaccinated against smallpox in Michigan as of May 13, 2003 • Public Health Response Team Members: 249 • Health Care Response Team members: 425 • Other: 15

  11. Adverse Events after vaccination, Michigan • Expected reactions • No serious • 2 non-specific chest pain • 1 episode elevated blood pressure • 1 r/o encephalitis, unrelated hospitalization

  12. Civilian Adverse EventsNational – As of 5/9/03 36,217 vaccinees • 1 Generalized Vaccinia confirmed • 4 Inadvertent inoculation (self) confirmed • 2 Ocular Vaccinia confirmed Source: MMWR, May 23, 2003

  13. Cardiac events • Myocardial Infarction: 6 as of May 9 • Myocarditis (inflammation of heart muscle tissue): 15 as of May 9 • Pericarditis (inflammation of membrane surrounding heart): 6 as of May 9 • Angina (chest pain due to insufficient blood flow to heart): 3 as of May 9

  14. Cardiac events & smallpox vx • Myo- & peri-carditis previously described in European & Australian literature • May be causal association • Other cardiac events (MI, angina) not previously associated with smallpoxox vx • Coronary artery disease is common, hard to determine if event is causally associated or coincidental

  15. Changes to program • As of April 1, pre-vaccination screening includes assessing history of heart disease and presence of risk factors.

  16. Phase 2? • Not here, not yet

  17. A little about HAN • Internet-based software application that can alert public health partners by telephone, e-mail, text pager, and in limited instances fax • Over 50% of the 1,850 Phase 1 licenses will be LHD staff and their designees • HAN users must have access to a reliable, high-speed Internet connection

  18. Health Alert Network Training • Training for system administrators, trainers, and some state and local staff will occur the week of June 9th in Lansing • Regional training for all local staff and their public health emergency response partners will occur in July at times and locations to be determined

  19. What’s next? (not “What next?!?”)

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