Vaccinating health care workers against smallpox in an isolated primary care facility

Abstract

Just as civilian emergency response teams and health care workers in the United States are being immunized against smallpox, primary care facilities in rural or isolated areas are being confronted with the need to develop terrorism response plans, including smallpox vaccination programs (1). Many are reluctant to administer or receive the vaccine because of concerns about potential side effects, lower productivity, and providing compensation for medical expenses or lost wages to workers with persisting adverse reactions to the vaccine (2–8). In April 2003, only a fraction of health care workers and first responders who were scheduled to receive the vaccine did receive it (8,9). By July 2003, national security experts feared that the smallpox immunization program was all but dead (8). Some states such as Arizona and Nevada have immunized fewer than 50 people (8). Washington state has immunized only 543 of their initial goal of 7000 medical personnel (8).