The California Nurses Association (CNA) announced its opposition to the Bush
Administration's smallpox vaccination program scheduled to start this Friday.
CNA is actively encouraging all California hospitals to not participate in
the program. The Association is actively discouraging its 50,000 Registered
Nurse members from receiving the vaccine. To date over eighty hospitals have
refused to participate citing minimal benefit and genuine risks. The esteemed
Institute of Medicine issued a report last week stating that the plan is too
rushed and lacks adequate safeguards. CNA's position is based on the
following reasons:
1. There is no proven evidence of the likelihood of a smallpox attack.
However, there are known dangers from a smallpox program both to caregivers
and their patients. Those include severe life-threatening skin reactions,
brain inflammation, and non-life threatening skin reactions including
blindness and toxic rash. The CDC estimates 30% of those vaccinated will be
unable to work for a period of time. An ancillary danger is secondary
transmission from the live vaccine form caregivers to patients and family
members. Alternatively, the vaccine is effective up to four days from
exposure.
2. Compensation and liability issues: The federal government has failed to
provide compensation programs for individuals harmed as a result of the
vaccination program, while offering liability exemptions for pharmaceutical
corporations that profit from the program.
3. Diversion of funds jeopardizes essential preventive health care programs:
Local health departments across the US are reporting that the diversion of
funds for the smallpox program is shifting vital resources from proven
epidemiological dangers such as tuberculosis screenings and immunization
clinics for children.
4. Opposition to a unilateral war against Iraq: The smallpox program inflames
public fears contributing to efforts to generate support for an ill-conceived
war. CNA condemns all acts of terrorism against civilians and endorses
international initiatives by the United Nations to promote disarmament
through peaceful means.
"I will not get the vaccine and I will encourage nurses in my facility and
throughout the state to do the same," said Malinda Markowitz, RN, a nurse at
Good Samaritan Hospital in San Jose, California and a CNA board member. "I
will not put my patients at risk and my license in jeopardy. The risk of
secondary infection is too dangerous to expose patients in a hospital
setting." "This program is being rushed through despite serious concerns and
growing opposition throughout the health care community," said Kay McVay, RN,
CNA President. "It puts patients and healthcare personnel at great risk and
only serves to fuel public fear for a war we should not be waging."
CNA calls smallpox program "political"
Nursing union official says Bush's plan carries more risks than benefits
<http://www.calnurse.org/12403.html>
Matt Krupnick, Contra Costa Times, January 24, 2003
The state's largest nursing organization on Thursday urged hospitals and
nurses not to participate in a proposed smallpox vaccination program. The
50,000-member California Nursing (sic) Association said President Bush's
plan to inoculate up to 10.5 million health-care workers and emergency
responders carries more risks than benefits, and the proposal is meant more
to advance a war with Iraq than save lives. "We feel this smallpox program
has been made for political reasons, not public health reasons," said
Lisabeth Jacobs, an association spokeswoman. "What it's doing is inflaming
public fears." The nurses' opposition adds to a wave of wariness about the
smallpox plan. Some of the nation's largest unions have opposed the program,
and most California hospitals have yet to order the vaccine. ...
1214EST0059.DTL>
Associated Press, January 24, 2003
Sacramento - California's largest nursing union is discouraging its members
from participating in the nation's voluntary smallpox vaccination programs.
The California Nurses Association, which represents 50,000 registered nurses,
joined a growing number of critics Thursday. The national plan calls for the
inoculation of a half-million medical personnel as a precaution against a
bioterrorist attack. However, the nurses union wants the state to delay the
plan amid worries there aren't enough safeguards in place to ensure people at
high risk of injury aren't vaccinated. Health officials have said the
smallpox inoculation is the most dangerous vaccine available, historically
killing one to two people per 1 million vaccinated. It can cause serious side
effects, including runaway infection and brain inflammation. The nurses union
also worries that someone who has just received the vaccine could be
contagious. ...
The Massachusetts Nurses Association (MNA) has been actively involved in the
collaboration with the Massachusetts Department of Public Health (DPH) and
other agencies to plan and make preparations for an act of bioterrorism
involving the smallpox virus. Clearly, registered nurses who function in all
areas and venues of health care delivery, be it in the school system, public
health departments, acute, community, home and long term care settings, will
and must play an integral role in the provision of effective health service
in the event of a bioterrorist attack. Consistent with this, nurses represent
the majority of those health care workers slated to be vaccinated as part of
the plan proposed by the DPH.
As to the plan that has been developed, we recognize the great efforts that
have gone into its creation and we strongly support the decision to make
participation by health care workers in the vaccination plan completely
voluntary. However, there are a number of areas of this plan that have and
continue to raise concerns within the MNA, among our members and in the
broader nursing community. In light of the fact that the state is proposing
to move towards rapid implementation of this plan, we wanted to take this
opportunity to formalize these concerns by putting them in writing, as well
as to make clear our position on these issues.
Concerns raised are as follows:
Need for Information and Education: The implementation plan for this program
is moving at a rapid pace, allowing little or no time for appropriate and
comprehensive education of the workforce about the plan. A first step, prior
to any vaccination, must be the introduction of a mandatory education program
on the smallpox vaccine for all potential smallpox responders, their
household contacts and co-workers who may be exposed to the vaccine virus.
Safety of Proposed Vaccine: The vaccine that has been chosen for use under
this plan is more dangerous than that chosen and utilized to vaccinate the
health care workforce in Israel. Given the risks involved with a large scale
vaccination plan, utilization of a safer vaccine to minimize any negative
impacts of this program would be preferable.
Safety of Needles to Deliver Vaccination: The needles proposed to be used are
unsafe and fail to comply with the Needlestick Safety and Prevention Act of
2000 designed to protect health care workers and patients from accidental
needlesticks. The MNA's position is that the state should only implement a
vaccination plan using the safest needle technology. In addition, it should
be assured that the stoppers used on the vaccine vials are not made of latex,
which would present an inherent danger of serious complications due to
allergies to latex experienced by up to 17% of health care workers. No
needles or syringes should be used that contain latex material.
Furloughing of Volunteers: The absence of a provision for furloughing
(providing leave rights) volunteers presents the most serious problem, not
only for those vaccinated, but also as it relates to the increase in risk for
exposure to others, including patients and co-workers. Given that experts
project that as many as one in three people who are vaccinated will feel too
sick to work or to provide proper care for one or more days, and given that
those vaccinated are at risk for exposing another person up until the time
the vaccination scab dries and falls off (between 7 and 14 days), we believe
the safest and only prudent course of action is to provide paid furloughs to
those who volunteer for the vaccine. The MNA believes it is unreasonable to
expect any volunteer to suffer any loss of pay or accrued benefit time as a
result of participating in this voluntary program. Without furloughing
provisions, and given the current malpractice liability for nurses who
participate (see item on malpractice below) taking such an unnecessary risk i
s unacceptable.
Liability: There are a number of components here. 1) There is no malpractice
protection for vaccinated nurses in the event a patient is exposed. In fact,
we have queried our malpractice insurer and they made it clear that they will
not cover such a claim nor will they underwrite a rider to cover this on
their policy - in large part because the plan does not mandate the
furloughing of those vaccinated. 2) There is no malpractice protection in the
event of inadvertent exposure of a colleague who may have expressly not
volunteered for health or other reasons. We do not believe the Homeland
Security Act provides necessary clarity in these matters to move forward.
Workers' Compensation: In the event an individual vaccinated is symptomatic
or an exposed colleague of the vaccinated individual becomes symptomatic,
there is a lack of clarity on what coverage shall exist under the state's
Workers' Compensation law. A clear and direct answer on this issue has yet to
be offered. We strongly urge that a definitive answer to this question be
given and the information shared with volunteers before the plan is
implemented. The MNA's position is that Workers' Compensation should be
guaranteed, and that no worker should suffer financially for time lost due to
illness or injury related to this plan.
CONCLUSION
This position statement identifies the outstanding concerns and issues of the
MNA. Let us be clear: we agree that as a society we must prepare for the
event of a bioterrorist attack, including, but not limited to
smallpox. However, the timetable and the process proposed under this
particular plan is fraught with problems at this time. If the ultimate goal
is to generate broad-based participation among nurses and other health care
workers, to allay their fears and to protect the public health, the current
timetable and process may not succeed. We, therefore, urge the state to take
the time and effort to address the concerns outlined, as well as those raised
by other key participants in this process, to develop a plan that will
protect the personal, financial and legal interests of the volunteer
participants.
Again, the MNA remains committed to working with the DPH and all other
interested parties to ensure that an effective preparedness plan is developed
to protect the public's safety and health. Pending adequate resolution of the
important issues we have raised, the MNA cannot encourage participation by
our members in the smallpox immunization plan.
tml>
Ken Maguire, Associated Press, January 21, 2003
Boston - The state's smallpox immunization program doesn't protect the
''personal, financial and legal interests'' of nurses, the largest nurses'
union in Massachusetts said on Tuesday. The plan allows no time for smallpox
education, and would immunize people using substandard needles and vaccine,
the Massachusetts Nurses Association claimed in announcing that, for now, it
could not encourage its members to participate. The union said its ''most
serious problem'' is that the state's plan doesn't offer paid leave for
nurses who get sick after the shot. They should get at least seven days leave
if needed, the MNA said. Department of Public Health officials say they're
confident the nurses will participate after federal government distributes
educational material in the next two weeks. ''No matter what we do, nurses
are going to be the key to our response plan,'' said Dr. Alfred DeMaria,
director of communicable disease control at DPH. ''Without nurses, we're in
trouble across the board.'' The DPH will ''absolutely address all these
questions,'' but won't support paid furloughs, he said. ...
shtml>
Stephen Smith, Boston Globe, January 22, 2003
The 20,000-member Massachusetts Nurses Association yesterday urged the
state's nurses not to volunteer for smallpox shots until the state resolves
important safety and legal liability issues, representing the largest group
so far to rebel against President Bush's campaign to prepare for a possible
bioterrorism attack. The announcement by the nursing group came less than a
week after physicians at Cooley Dickinson Hospital in Northampton declared
that they would not be rolling up their sleeves for smallpox inoculations,
citing fears about potentially exposing patients to the live virus contained
in the vaccine. If rank-and-file nurses heed the call of the state's largest
nursing organization, it could cause severe disruption of efforts by the
Massachusetts Department of Public Health to vaccinate 10,000 health care
workers starting in mid-February. A majority of those to be vaccinated are
nurses, and vaccinated nurses, in turn, are supposed to take a leading role
in administering the shots as the campaign unfolds over several months.
''We're not trying to sink this and say this is totally wrong, but we think
there are concerns that need to be addressed before we proceed,'' said Karen
Higgins, president of the Massachusetts Nurses Association. ''Our concern is
it's moving so fast that some of the concerns are not being addressed, and we
think they need to be before you put anybody at risk.'' The pronouncement
from the Massachusetts group, prompted by a flood of calls from worried
members, marks the first time a statewide nursing or physician organization
has actively advocated that members not be vaccinated against smallpox,
according to a spokeswoman for the American Nurses Association. ...
The Massachusetts Nurses Association has joined the growing chorus of critics
of the federal-state smallpox immunization plan. ``The timetable and the
process proposed under this particular plan is fraught with problems at this
time,'' the MNA said in a statement. The nurses group said it was concerned
with the issues of safety, lack of information, liability, workers'
compensation and the decision not to furlough hospital workers who get
voluntary shots. Until their questions are answered, the organization said it
``cannot encourage participation by our members'' in the voluntary smallpox
immunization plan. ...
ry/22-3588-news12.txt>
Sue Reinert, The Patriot Ledger, January 22, 2003
The union representing 20,000 Massachusetts nurses has become the second
health care organization to opt out of the state's smallpox vaccination plan.
The Massachusetts Nurses Association won't recommend that its members
volunteer for shots until ''important issues'' of safety and compensation are
resolved, the union said yesterday. ''We do believe we need to be prepared
(for a bioterrorist attack with the smallpox virus),'' said Karen Higgins of
Weymouth, president of the union and an intensive care nurse at Boston
Medical Center. ''But we don't have an outbreak of smallpox, so why are we in
such a rush?'' Higgins said. ''We are not getting clear answers to our
questions.'' ...
The last thing the federal government should want as it prepares the nation
for a possible terrorist attack with the smallpox virus is any miscues that
undermine its credibility with the public or with health care workers. The
plan to mandate vaccination of 500,000 members of the armed services and
voluntarily inoculate 500,000 civilian medical personnel should be so
carefully organized that few if any civilians will refuse. The announcement
Tuesday by the Massachusetts Nurses Association that it would not encourage
its members to be vaccinated because of a range of uncertainties is the
second alarm bell in a week for the Bush administration. Last Friday the
Institute of Medicine expressed concern that the the plan to begin civilian
vaccinations next week left too little time for training, education of
vaccine recipients and the general public, and issues like liability and
compensation for lost time. ...
Nurses hit for criticizing smallpox plan
The Patriot Ledger, January 23, 2003
An organization representing nursing managers is criticizing union nurses for
questioning the state's smallpox vaccination plan. "We think their statement
is premature until all the facts and figures are in," Sally Millar, president
of the Massachusetts Organization of Nurse Executives, said. On Tuesday, the
Massachusetts Nurses Association said it would not recommend that its 20,000
members volunteer for smallpox shots until issues of safety and liability are
resolved. The vaccine can cause serious side effects not only in those who
are vaccinated but people in close contact with them. Cooley Dickinson
Hospital in Northampton has also opted out of the program. Doctors said they
were worried about the safety of patients. Millar, director of patient
advocacy at Massachusetts General Hospital, said the nurses are "raising
valid concerns" but the union shouldn't have questioned the program publicly.
"We are at a time of war and health care professionals should not be airing
their concerns in the press," Millar said.
Editorial Comment: MONE is an affiliate of the American Organization of Nurse
Executives, a wholly-owned subsidiary of the American Hospital Association.
In September 1994, when several hundred nurse-activists assembled in Canton
to decry the threats to the integrity of the nursing profession caused by the
reorganization of health care in Massachusetts along industrial lines and to
launch the Statewide Campaign for Safe Care, these self-styled nursing
leaders offered the only opposition to a public campaign to educate the
public and build support for solutions. When the first safe staffing bill was
introduced, this tool of the hospital industry testified against it, dubbing
the proposed legislation the "full employment bill for nurses." MONE has
consistently campaigned against mandated minimal RN-to-patient staffing
ratios, thus providing cover for vacillating legislators. - SE
Subject: MNA Makes Headlines Over Its Position on Smallpox, Wins Support
of Boston Globe Editorial Board and Concerned Citizens
Date: Thu, 23 Jan 2003 11:55:59 -0500
From: "David Schildmeier" <dschildmeier@mnarn.org>
The MNA has garnered significant local and national media attention for its
position criticizing the smallpox pre-event vaccination plan, including
winning a supportive nod for our position in the lead editorial of today's
Boston Globe. The editorial and a sampling of recent news coverage can be
found in this message. But the most important endorsement received by the MNA
to date has come in the form of a phone call from a citizen who is among
those most vulnerable to a life-threatening exposure to the vaccinia virus as
a result of this program. We have transcribed a voice mail message from a
person with Lupus, an autoimmune disease, which speaks volumes of what the
MNA position is all about.
There is no need to call me back. I just wanted to leave a message to let the
association know that as a person who suffers from autoimmune disease, I have
Lupus, I was more than thrilled this morning to hear of your association's
position. I commend you. I hope you're getting other calls like this. I've
already called the Mass Medical Society to urge them to do the same thing and
follow your lead and I think there are many people like myself who feel
terribly frightened ... I go to hospitals all the time, so I strongly,
strongly urge you to keep up this position and spread the word and I thank
you very, very, very much as a private citizen. Thank you.
Smallpox vaccinations begin
Poor turnout seen in Conn. as doctors fear side affects (sic)
Rick Collins, The Patriot Ledger, January 25, 2003
Smallpox vaccinations began in Connecticut Friday with many of the same
questions that have made doctors and nurses in Massachusetts reluctant to
join in the effort to vaccinate 500,000 health care workers nationwide in
case of a bioterrorist attack. Although 20 doctors were originally expected
to help kick off the program in Connecticut, only four volunteered. The
paltry response was attributed to the risk of potentially deadly side effects
from the vaccine. Connecticut is the first state to participate in the
federal government's smallpox vaccinations. Health officials, hospitals and
nursing unions in Massachusetts have expressed reservations about the program
in recent weeks. "It would be one thing if we were in the middle of a known
attack, but where this is simply prophylactic, it seems to be an unnecessary
risk," said Stephanie Stevens, an operating room nurse at Jordan Hospital in
Plymouth. Widespread vaccinations ended in 1972 when federal health officials
declared smallpox eradicated. Fears over bioterrorism prompted President
George W. Bush to order voluntary smallpox inoculations for front-line health
care workers. Liability and safety issues remain unresolved, prompting some
groups to declare the inoculations not worth the risk, including the
Massachusetts Nurses Association, which represents 20,000 nurses across the
state. Health officials predict about two deaths per 1 million people
immunized, and another 14 to 52 people per million could experience
life-threatening side effects. Nurses are not eligible for paid furloughs if
the vaccination makes them sick, and the federal government has said most
nurses won't receive liability coverage if they infect a patient. Sandy
Eaton, a nurse in Quincy Medical Center's critical care unit, said he would
rather use safety precautions, such as gowns and masks, if ever faced with
treating a smallpox victim. "I don't want to take any vaccination that may
put my patients or family at risk," Eaton said. Although the federal Centers
for Disease Control did not release an information packet about the smallpox
vaccination program until Thursday, some hospitals had already begun internal
employee education programs. Stevens said Jordan Hospital officials tried to
address the issue in a recent newsletter. Quincy Medical Center has invited
special guest speakers to address hospital staff, and distributed
informational packets to employees. "What we're doing is trying to do the
right thing in educating the staff so when the time comes, they can make a
proper, informed decision," said Dr. Thomas Barber, the hospital's chief of
medicine Hospital officials hope some of the concerns will be resolved during
a meeting Tuesday between state public health officials and the Massachusetts
Hospital Association. "A lot of key questions remain unanswered," said Scott
Pickard, spokesman for South Shore Hospital in Weymouth. David Young,
spokesman for the hospital association, expects a packed room. "We know
concerns have been high and brought forth by many in the hospital community,"
Young said. "This is a step-by-step process, and we're moving ahead very
slowly and very cautiously." Dr. Alfred DeMaria, coordinator of the state's
inoculation program, said people shouldn't rush to judgment when deciding
whether to volunteer for the vaccine. "There are well-crafted questions that
need to be answered," he said. "When we do answer all these questions I hope
people do reconsider what their decisions are." DeMaria said Congress is
working on legislation that would create a special fund to cover any
liability suits stemming from the vaccination program. He said Massachusetts
is also considering a measure that would compensate employees who miss work
due to the inoculation.
Vaccinate Against War Not Smallpox
As health care professionals, some of us are being called upon to receive the
smallpox vaccine. We are being asked to become vaccinated against a viral
disease that we had been told was eradicated. The obliteration of this
disease marks one of the highest points of international cooperation.
Governments with opposing ideologies, governments that were on a daily alert
against each other, governments that were funding armed conflicts against
each other all cooperated in eradicating smallpox. Western scientists
cooperated with tribal healers, communists cooperated with capitalists,
dictators cooperated with democratic leaders, people of all religions
cooperated with each other. Yes, Muslims, Christians, Jews, Hindus,
Buddhists, pantheists and atheists all cooperated to erase the threat of
smallpox from the world. Now the American people are being told that the
scourge of smallpox is near upon us. We are being told that the international
era of cooperation in combating worldwide diseases is over. We are being told
that our health care system will protect us, that our armed might will
protect us. As health care providers who are likely to be called upon to
accept the smallpox vaccine, we say NO. We say NO not out of fear for our own
health. Every day we face the risk of infectious diseases at work. We have
never shied away. We say NO not out of fear of side effects to the vaccine.
We do not believe ourselves to have any risk factors for a bad reaction since
we were vaccinated as children and had no problems. We say NO because
vaccinating in the face of no known threat is wrong. It represents the use of
health care as an extension of an aggressive military posture. A posture
which our government has put forward prior to national debate. The posture
that we as a nation have not only the right but also the responsibility to
launch preemptive war. There is no true evidence of anyone preparing a
smallpox attack. Those who are knowledgeable enough to launch a mass smallpox
attack via aerosol distribution are also knowledgeable enough to know that it
would not only backfire politically but that smallpox would spread world
wide, affecting their people as well. Those who are fool enough to use
suicidal methods to spread smallpox would ultimately be defeated, since we
were able to defeat the original smallpox epidemics when the virus was spread
by individuals unwittingly infected The government is using the fear of
smallpox as a political tool to rally support for a wrong and possibly
criminal policy. It reminds one of the 1950s. Those of us who were children
then remember the fear of the communist nuclear attack. In gym classes, in
civics classes and in health classes we were shown films of what would occur
if the Russians sent atomic bombs and missiles at us. We had regular air raid
drills to prepare us for this event. We sat under our desks and in hallways
with our heads between our legs. We were told not to look at the flash of the
explosion lest it blind us. Ads for backyard fallout shelters were in all the
media. Fear abounded and bred hatred and a pro-war politic. A politic which
led our democratically elected government to fund dictators throughout the
world. A politic that led our democratically elected government to support
military overthrow of democratically elected governments. A politic which led
government officials, charged with protecting our own freedoms, to brand the
civil rights movement, the voting rights movement and even some of our unions
and environmental movements as conspiracies run from Moscow. Let us not go
there again. We must use our healthcare abilities to build an international
commitment to peace and human rights. Let the example of smallpox eradication
be used to build further cooperation. There is new work being done on drugs
to conquer malaria, to diminish the effects of HIV. Let us use this and other
work to enhance international unity instead of hate and fear. Let us use our
wealth and knowledge to aid people in developing clean water and safe sewage
systems. Let us use our democracy as an example for others. We can do that by
not supporting dictators, royal families and governments that hoard their
countries' wealth for a few while oppressing the human rights of the
majority. Let us wage a peaceful campaign against all Weapons of Mass
Destruction in all countries and by all governments. As healthcare
professionals we have pledged first to do no harm. We have pledged to use our
skills to help all those in need regardless of their beliefs or their
position in society. We will accept the smallpox vaccination when it is part
of a worldwide effort to eradicate the disease. In that event the healthcare
workers of Iraq would be inoculated as well.
Barry Adams, RN, Boston, Massachusetts
Iris Biblowitz, RN, San Francisco, California
Amelia M. Cabral, RN, Taunton, Massachusetts
Catherine DeLorey, RN, Boston, Massachusetts
Mike D'Intinosanto, RN, Winchendon, Massachusetts
Sandy Eaton, RN, Quincy, Massachusetts
Robert Fine, RN, Arlington, Massachusetts
Susan Flowers, RN, Indiana, Pennsylvania
Teana Gilinson, RN, Stoughton, Massachusetts
Patty Healey, RN, Northampton, Massachusetts
Peggy Lynch, RN, Cambridge, Massachusetts
Michael Lyon, MS, San Francisco California
Deborah Blaisdell Martin, RN, Waltham, Massachusetts
Jim Moura, RN, Dorchester, Massachusetts
Marc Sapir, MD, MPH, Berkeley, California
Leaders of the state's two largest health-care unions yesterday urged their
members not to volunteer for smallpox vaccination, saying the government's
plan endangers health-care workers, their families and their patients. Linda
McDonald, president of the United Nurses and Allied Professionals, which
represents workers at Rhode Island Hospital and elsewhere, said the plan to
vaccinate 1,200 health-care workers in Rhode Island is "hasty and
ill-conceived" and "may do more harm than good." She was joined at a news
conference by leaders of Local 1199 of the New England Health Care Employees
Union, which represents workers at Women & Infants Hospital and many nursing
homes. With their announcement, the local unions followed in the footsteps of
the Massachusetts Nurses Association, the Bay State's largest nurses' union,
which on Tuesday urged its members to avoid smallpox vaccination until safety
and liability concerns are addressed. Additionally, the medical staffs at
some 80 hospitals around the country have declined to participate. Union
officials yesterday pointed out there is no immediate threat of smallpox,
which has been eradicated, but the vaccine can make people ill. ...
491&rfi=6>
Doug Bloom, The Pawtucket Times, January 23, 2003
Pawtucket - The state's largest union of health-care workers is urging its
members to refrain from participating in the state's smallpox immunization
program unless changes are made. Leaders of the United Nurses and Allied
Professionals held a press conference Wednesday at their Providence
headquarters to announce that they are urging their members as well as other
Rhode Islanders not to volunteer to receive a smallpox vaccination. UNAP
represents more than 4,000 registered nurses, technologists, therapists,
nurse assistants and other service and maintenance workers in union locals
throughout the state. According to UNAP President Linda McDonald, union
members voted against the smallpox immunizations. President George W. Bush
has called for a national vaccination program for health-care workers, saying
it's needed to protect the country against a possible bioterror attack. ...
Nurses Respond - USA:
A Pledge: Not to Get and Not to Give
<http://www.healthworkers.org>
Health Workers Against Smallpox Vaccinations
The Bush program to vaccinate all health care workers against smallpox is
unscientific, unethical, and most importantly dangerous. The program seems
designed to validate his war agenda rather than to protect the public's
health. Vaccinations are appropriate when the benefits clearly outweigh the
risks of side effects. This is not the case with the smallpox vaccine.
Adverse effects from smallpox vaccine can include painful swelling,
infection, rash, joint pain, malaise and fever. Perhaps a third of those
inoculated may have to stay home one or more days, as with flu-like illness.
Severe rashes, blindness, inflammation of the brain, and even death are
possible though rare. Serious complications were reported at the rate of
49-900 per million and life threatening ones at 14-52 per million. Some 50
million people in the U.S. with eczema, HIV/AIDS, cancer, lupus, other immune
disorders, and atopic dermatitis are at higher risk of more serious
reactions. Since it is a live virus vaccine (vaccinia: a cowpox virus) people
who get the vaccination can transmit it unwittingly to others for 3 weeks
after inoculation including to family members and high-risk patients.
Smallpox vaccinations have so many adverse side effects that the drug
companies have insisted on legal exemption from civil suits for illness and
death arising from the vaccinations. Bad experiences from unwarranted mass
inoculations could undermine public confidence in all immunization programs
and in the competence of health workers to protect the public's health. In
the very remote chance that an outbreak was to occur, the former plans for
quarantines and ring vaccinations might be appropriate. But there has not
been a single case of smallpox in the world for over 20 years and even the
Bush administration admits that there has been no evidence of any danger of
an outbreak. Why, then, carry out mass vaccinations? Generating fear and
hysteria over smallpox may be an effort to gain public support for an unjust
and unpopular war against Iraq, for spending even more billions on the
military, and for eroding civil liberties. Let us remember the anthrax
outbreak in 2001 that killed 5 people was initially blamed on "foreign
terrorists." Federal investigators admitted months later that the evidence
points to a scientist from a US military laboratory. Expanded research on
smallpox and vaccines could increase the number of individuals handling
smallpox virus and thus actually increase the risk of some terrible accident
or crime from a similar source. Clearly the risks of the smallpox vaccination
campaign far outweigh any presumed benefit. We don't have to go along with it.
The Health Workers Pledge
As a health worker, my responsibility is to prevent disease, treat illness
and promote health. My obligation is to help, and above all, do no harm.
Smallpox vaccination has known and potentially serious side effects. In the
absence of any evidence of exposure or risk of exposure to smallpox virus, it
is unethical and a threat to my health and the health of the patients and
public that I serve to administer unnecessary vaccine. Military personnel are
unfairly being forced to get the vaccine and this should be stopped. As a
health worker I am being given a choice, and I choose NO! I will not be
pressured to risk my health and the health of patients. I will not
participate in a campaign that is against the best interests of the public I
serve. I hereby pledge that, in the absence of evidence of exposure, I will
not get and will not give smallpox vaccinations.
P.shtml>
Stephen Smith, Boston Globe, January 25, 2003
Farmington, Conn. - It took only five seconds - and 15 rapid-fire jabs from a
two-pronged needle - for Dr. James Hadler to achieve his spot in medical
history yesterday. Baring his left arm in a hospital dining room, Hadler
became the first person to be vaccinated against smallpox on the first day of
a national campaign that aims to inoculate as many as 500,000 health care
workers against a virus that last struck humans in 1977. It was the potential
use of smallpox as a weapon that spawned the scene at the University of
Connecticut Health Center as Hadler and two other physicians received a
vaccine renowned both for its effectiveness and its unusually high rate of
complications. ''I just went through deja vu of what I last went through ...
when I was last vaccinated,'' said Hadler, Connecticut's top disease tracker.
''I did it because it's important for the country to be more prepared for
smallpox than it was before. Today was as good a day as any to start.'' As
Connecticut embarked on a vaccination campaign that could eventually
inoculate 6,000 doctors, nurses, and other health care workers, the state
confronted the same difficulties and dissension that have swept public health
departments across the nation. The union that represents 1,900 workers at the
health center, for example, recommended that its members not be vaccinated
until they know for certain that if they fall ill from the inoculation, they
will continue getting paychecks and have their medical bills paid. Smallpox
shots are made from a molecular cousin of the smallpox virus and carry a
substantially higher rate of side effects than the immunizations that US
parents are accustomed to watching their children get. Experience with the
smallpox vaccine in the 20th century showed that for every 1 million people
receiving the inoculation, one or two died and up to 49 developed a serious
illness. Concerns about those side effects - and their financial and legal
implications - prompted the University Health Professionals AFT Local 3837 at
UConn to forge an agreement with the health center that its members would not
be vaccinated until the union's concerns are addressed. ''We want to know
that the workers who put themselves at risk will be taken care of in every
possible way,'' said Renae Reese, the union first vice president. ...
TOKEN=98016248>
The Associated Press, December 30, 2002
Augusta - Smallpox vaccinations are expected to begin in Maine in February
with inoculations of teams of medical professionals who would be the first to
respond to any suspected outbreak of the deadly disease. The vaccinations are
part of a national preparedness plan should terrorists gain access to the
smallpox virus and release it against civilians. The first round of
vaccinations will involve 100 volunteers who are members of groups that would
likely respond to any smallpox outbreak, said Dr. Stephen Sears, chief
medical officer for MaineGeneral Hospitals. Once those people are inoculated,
the state plans to vaccinate another 3,000 medical professionals beginning in
March. Those people will be nurses, doctors and others who will make up
health care response teams at each of Maine's hospitals. ...
TOKEN=98016248>
Michael O'D. Moore, Bangor Daily News, January 8, 2003
Whether many Maine hospitals will volunteer to create smallpox response teams
remains unclear as they contemplate serious unknowns and risks related to the
vaccinations of doctors, nurses and other medical workers. Late last week,
Maine's Bureau of Health sent a detailed four-page letter to hospital
administrators and infection control officers describing the apparent health
and liability risks. "There are a lot of issues for them to grapple with,"
said Dr. Dora Anne Mills, director of the bureau. Under the state plan
created at the behest of the Bush administration, 100 medical workers are
supposed to be vaccinated next month. Those same medical workers will help
vaccinate at three facilities the hospital teams that would be available to
treat smallpox victims. A key concern for hospitals is that they may not be
protected against medical and liability claims from employees and
nonemployees who suffer possible side effects from the vaccine. The Homeland
Security Act protects the state and federal governments, the vaccine
manufacturer and the facilities where vaccinations are administered from
lawsuits. But it doesn't provide indemnification for hospitals whose
employees volunteer for vaccination, according to the Centers for Disease
Control and Prevention in Atlanta. The CDC's interpretation surprised the
American Hospital Association, which thought hospitals would be protected
when the law was passed, said Sandra Parker, counsel for the Maine Hospital
Association. ...
Northampton - Calling President Bush's recommendation that the nation's 10.5
million medical personnel be vaccinated for smallpox a policy that makes "no
sense at all," Cooley Dickinson Hospital announced Thursday that it will not
encourage its 200 employees to get the vaccine. Bush in December announced
that as a precaution against biological terrorism, health care workers should
be vaccinated. Dr. Ira Helfand, president of Cooley Dickinson's medical
staff, said that the hospital staff held a "very extensive discussion" about
the proposal. "There was an astonishing degree of unanimity," Helfand said,
"that this policy made no sense at all." He said the chances of a major
smallpox incident are so remote that the hospital concluded the risks of the
vaccine would outweigh any benefits, particularly since the vaccine is
effective even after a person is infected with the disease. ...
y/17-3284-news12.txt>
Sue Reinert, The Patriot Ledger, January 17, 2003
A hospital in western Massachusetts won't participate in the state's smallpox
vaccination plan later this month, citing doubts about exposing vulnerable
patients to possible infection from the vaccine. Cooley Dickinson Hospital in
Northampton announced the decision yesterday. It is the only Massachusetts
hospital so far to break ranks on the vaccination program, which state and
federal officials say will prepare the state to treat patients if there is a
bioterrorist attack with smallpox virus. But several hospitals elsewhere in
the country have refused to participate. In addition, Massachusetts hospital
officials and hospital employee unions say they're worried about who will pay
if a worker or patient suffers serious side effects from the vaccine. ...
Cooley Dickinson Hospital in Northampton has become the first in
Massachusetts to opt out of the state's voluntary smallpox vaccination
program, which state officials said yesterday has been pushed back about a
month. ``There is no compelling reason at this time'' to participate in the
program, said Dr. Ira Helfand, president of the medical staff. ``While there
is no imminent danger of smallpox, the vaccination of hospital personnel
poses a risk to patients at this time.'' The hospital's medical executive
committee said it would not encourage workers to be vaccinated unless a
smallpox case has been reported. Dr. Alfred DeMaria, chief of infectious
diseases for the state Department of Public Health, questioned the hospital's
move. ``It's a little premature,'' he said. ``The final recommendations
aren't even done.'' DeMaria said the first health workers, from DPH staff,
will now be vaccinated in mid-to-late February, about a month later than
originally announced. ...
sP.shtml>
Stephen Smith, Boston Globe, January 17, 2003
Physicians at Cooley Dickinson Hospital in Northampton announced yesterday
they will not volunteer to receive smallpox inoculations, the latest evidence
of resistance among the ranks of medical personnel to participating in
President Bush's national immunization campaign. The hospital's medical staff
executive committee, including the chiefs of every department, voted
unanimously Monday against rolling up their sleeves for a vaccination that
federal authorities have said is necessary because of the threat of
bioterrorism. A top physician at Cooley Dickinson said yesterday that the
doctors' decision was prompted not by concerns for their own health and
potentially dangerous side effects. Rather, the doctors worried that after
receiving a vaccine made from a live virus related to smallpox, they could
inadvertently infect patients with that virus during the period when the
blistered immunization site heals. ''Our decision was taken primarily due to
our responsibility to our patients and our community,'' said Dr. Ira Helfand,
chairman of the department of emergency medicine and president of the medical
staff. ''We think we're doing the right thing. If other hospitals chose to
take the same position as a result of our action, I think we would consider
ourselves to have done a public service.'' The announcement came the same day
that two major unions for health care workers called for a delay in the
nation's smallpox immunization program, citing similar safety concerns. ...
Background Rhode Island:
Health department laying groundwork for smallpox shots
The plan is that inoculated health-care employees would better be able to
treat victims in case of a terrorist attack.
<http://www.projo.com/news/content/projo_20030123_pox23.d1d48.html>
Felice J. Freyer, Providence Journal, January 23, 2003
The Rhode Island Department of Health has begun recruiting health-care
workers to volunteer for smallpox vaccines, aiming to vaccinate some 1,200
people over the next few months. The Bush administration has instructed
health departments around the country to vaccinate a half-million health-care
workers against smallpox, so that they can care for smallpox victims if the
contagious virus - which does not exist in nature - is used in a terrorist
attack. But the state's largest health-care unions are urging their members
not to participate, saying the risks of the vaccine, which uses a live virus,
are too great. ...
Two prominent teaching hospitals are refusing to vaccinate their employees
against smallpox, rejecting President Bush's call for mass inoculation of
front-line medical workers who would be the first to confront a biological
attack. Officials at Grady Memorial Hospital in Atlanta and Virginia
Commonwealth University in Richmond said yesterday that the risk of dangerous
side effects of the vaccine and inadvertent transmission to patients outweigh
the remote threat of an attack with a virus that has not been seen since the
1970s. Three other large medical centers, Children's Hospital of
Philadelphia, Emory Medical Center in Atlanta and the University of Iowa
Hospitals and Clinics are leaning against inoculating their staffs. The
hospitals' decisions mark the first high-profile opposition from the medical
community to a plan Bush announced Friday to inoculate as many as 11 million
Americans by late summer and underscores some health workers' reluctance to
return to a decades-old vaccine known for its serious side effects. In rare
instances, the vaccine has caused life-threatening cases of encephalitis and
some deaths. "I don't like to cause disease," said Carlos del Rio, Grady
Memorial's chief of medicine, describing his fear that a hospital worker
could accidentally spread live vaccinia to a patient with a weakened immune
system. "If, say, a patient with AIDS became infected, that would be a
disaster." ...
_childrenP.shtml>
Laura Meckler, Associated Press, December 31, 2002
Washington - For decades, the vast majority of smallpox inoculations were
delivered to children, but in the new vaccination program now underway,
children won't qualify unless there's a bioterror attack, federal officials
said. Ethical and safety concerns bar children from clinical trials being
conducted now, meaning the vaccine cannot be licensed for them, said Dr.
Anthony Fauci, who oversees vaccine development and bioterrorism programs at
the National Institutes of Health. ''If Mom comes up to one of the local and
state health officials and says, `I want vaccine for my 5-year-year old,'
currently there doesn't appear to be a mechanism for them to get it,'' Fauci
said Saturday. Adults soon will have access to the vaccine, although it is
not being recommended for the public. Smallpox was eradicated in the 1970s
and, while experts fear that terrorists or hostile nations could unleash it
in an act of bioterrorism, President Bush said Friday there is no imminent
threat. ...
Washington - Government health officials insisted Friday that President
Bush's smallpox vaccination program would move forward as planned, despite a
drumbeat of calls to slow down. Just hours after a scientific advisory
committee urged the government to ``proceed cautiously'' and one day after
labor unions representing 60,000 registered nurses and 750,000 other health
workers asked for a delay, officials at the Centers for Disease Control and
Prevention announced the ``really good news'' that 11 states could begin
administering the smallpox vaccine as soon as next Friday. The CDC made the
announcement about an hour after accumulating requests for shipments of the
vaccine from the 11 states. Officials refused to identify the states. ``We
will ship the vaccine Tuesday,'' said Dr. Julie L. Gerberding, CDC director.
``This shows that states are ready to go.'' The CDC's spirited defense of the
plan to vaccinate as many as 10.5 million health care workers and police,
fire and emergency personnel in preparation for a possible bioterrorism
attack using the smallpox virus came in direct response to a report released
earlier Friday. In that report, a committee of the private Institute of
Medicine, which was convened at the request of the CDC, urged health
officials to move more slowly in implementing the plan, which it called ``a
program with inherent serious risks and with publicly unknown and unstated
benefits.'' ...
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