Although President Bush is not recommending smallpox virus vaccinations for the general public as a protective measure in the event of a terrorist attack, the White House is stockpiling enough vaccine to begin offering voluntary immunizations to every man, woman and child by 2004.

The first phase of the plan will be to vaccinate about 500,000 militarytroops deployed in high-risk parts of the world.

The second phase will be to vaccinate about 440,000 public health care workers, emergency room doctors, disease detectives and other hospital officials. Vaccination will be made available to up to 10 million police, firefighters and other first responders on a voluntary basis.

In anticipation of this announcement, the IAFC has built upon its prior efforts on this issue by establishing a new Smallpox Vaccination Working Group.

The purpose in forming the group was to assemble a number of EMS, hazmat and terrorism specialists from within the fire service to interface with the various federal agencies in addressing critical issues involved in making the vaccine available to fire service personnel.

In the event that a member of the Phase II vaccination group comes into contact with an actual smallpox patient prior to vaccination, they would be quickly identified by the investigative team and vaccinated after exposure. Unlike most trauma and chemical events, use of most biologic weapons, including smallpox, entails an incubation period. Smallpox vaccination has been shown to be extremely effective at preventing smallpox if given within four to five days of exposure. All contacts of a known case that have been identified, including any fire, EMS or public safety personnel, would be vaccinated to prevent the development of smallpox.

One of the primary issues of concern over the president's proposed plan involves the matter of the smallpox vaccine itself. Because of the nature of this live-virus vaccine, the smallpox vaccine has a much higher chance of side effects associated with it compared to most modern vaccines. In addition, the vaccine site is contagious for a period of time after vaccination and represents a potential hazard to those who come into close contact with the vaccinated individual.

During the first meeting of the new IAFC working group, immediate steps were taken in an effort to address such concerns from the perspective of the first responder community. As a result, the working group identified key issues and assigned the following actions:

• A list of questions was developed that will be sent to the Department of Health and Human Services which identifies several unique characteristics of the fire service that could complicate a smallpox vaccination program.
• A motion was made to the IAFC board of directors to consider revisions to the IAFC policy on smallpox vaccination for the fire service that will be submitted for consideration at the upcoming meeting Jan. 23-24.
• Key topics were identified to be covered in an upcoming IAFC publication that will provide fire chiefs with a reference guide on smallpox vaccination with an emphasis on administrative issues.

For more information on smallpox, visit the Centers for Disease Control/DHHS Web site at www.bt.cdc.gov/DocumentsApp/Smallpox/RPG/index.asp.