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SMALLPOX QUESTIONS AND ANSWERS for 12/9/02


Q. According to the New Jersey Smallpox Vaccination Plan, who will be immunized first?

A. The first group of people who will be vaccinated are volunteer public health workers who, in turn, will be able to vaccinate other health care workers in the future. We also plan to vaccinate public health response team members and hospital health care response team members.


Q. Who are on the Public Health Response Teams?

A. The Public Health Response Teams will be comprised of, but not limited to, a physician team leader, epidemiologist, public health nurse/vaccinator, a lab worker, law enforcement agent, regional planner/coordinator, a LINCS (Local Information Network Communication System) planner/coordinator and an industrial hygienist.


Q. Who are on the Hospital Health Care Response Teams?

A. Hospital health care response teams will be comprised of, but not limited to, emergency room physicians, infectious disease physicians, emergency room nurses and general nursing staff, infection control practitioners, and ancillary and security personnel.


Q. What will these teams do?

A. The Public Health Response Teams will be deployed to hospitals to investigate a high-risk patient, identify potential contacts, collect clinical specimens, and ensure safety precautions are maintained. The Hospital Health Care Response Teams will provide direct patient care and ensure proper infection control procedures, personal protective equipment and security are available.


Q. How credible is the smallpox threat to New Jersey?

A. At this time, the worldwide threat is uncertain. However, the New Jersey Department of Health recognizes that it is prudent to acknowledge the possibility of the threat and therefore realize the necessity to develop a guidance plan to protect NJ citizens. The Departments will rely on receiving additional updated information from law enforcement and federal and state intelligence agencies.


Q. Where will vaccination clinics be located?

A. The Department has identified six clinic sites, one in each of 5 regions (northeast, northwest, central east, central west, and south) and one in Newark, an MMRS site (Metropolitan Medical Response System). Department of Health and Senior Services staff will be assigned to each clinic location.


Q. How many people can be vaccinated in a day?

A. Initially, in the vaccination preparedness program, each clinic will vaccinate between 540 and 720 individuals per day. Each regional clinic will operate about one day a week for four weeks. Approximately 15,000 individuals will be vaccinated in this initial pre-outbreak scenario.


Q. How many doses of vaccine does New Jersey have now?

A. None. However, The Department of Health and Senior Services has requested 15,000 doses from the CDC for the initial vaccination preparedness program.


Q. When will the smallpox vaccine be available?

A. We are awaiting confirmation from CDC as to shipment dates. The shipments are anticipated within the next 4-6 weeks.


Q. Is there enough smallpox vaccine for everyone?

A. There is enough licensed vaccine available at this time to vaccinate individuals in the vaccination preparedness program (i.e., public health and hospital response teams). According to the information received from CDC, there will be enough vaccine to inoculate the entire country within the next 12-16 months.


Q. What is the cure for smallpox?

A. There are medications that can be used for supportive care (i.e., to treat the symptoms of smallpox). However, there is no "cure" for smallpox, and it cannot be treated with antibiotics.

Q. Are there side effects to the smallpox vaccine? How safe is the vaccine?

A. There are side effects and risks associated with the smallpox vaccine. Most people experience normal, usually mild reactions that include a sore or swollen arm, fever, and body aches. However, other people experience reactions ranging from serious to life threatening.


Q. Who are most likely to have serious side effects from the vaccine?

A. People most likely to have serious side effects are: people who have had, even once, skin conditions (especially eczema or atopic dermatitis) and people with weakened immune systems, such as those who have received a transplant, are HIV positive, are receiving treatment for cancer, or are currently taking medications (like steroids) that suppress the immune system. In addition, pregnant women should not get the vaccine because of the risk it poses to the fetus. Women who are breastfeeding should not get the vaccine. And people under 18 years of age and those allergic to the vaccine or any of its components should not receive the vaccine.


Q. How many people get side effects after being vaccinated?

A. In the past, about 1,000 people for every 1 million people vaccinated for the first time experienced reactions that, while not life-threatening, were serious. These reactions included a toxic or allergic reaction at the site of the vaccination (erythema multiforme), spread of the vaccinia virus to other parts of the body and to other individuals (inadvertent inoculation), and spread of the vaccinia virus to other parts of the body through the blood (generalized vaccinia). These types of reactions may require medical attention. In the past, between 14 and 52 people out of every 1 million people vaccinated for the first time experienced potentially life-threatening reactions to the vaccine. Based on past experience, it is estimated that 1 or 2 people in 1 million who receive the vaccine may die as a result. Careful screening of potential vaccine recipients is essential to ensure that those at increased risk do not receive the vaccine.

Q. Who should not get the vaccine?

A. People who should not get the vaccine include:

  • Anyone who is allergic to the vaccine or any of its components;
  • Pregnant women (in the absence of a smallpox outbreak, pregnant women should not be vaccinated because of the risk of fetal infection with vaccinia virus);
  • Women who are breastfeeding;
  • Anyone under the age of 18;
  • People who have, or have had, skin conditions (especially eczema and atopic dermatitis);
  • And people with weakened immune systems, such as those who have received a transplant, are HIV positive, are receiving treatment for cancer, or are taking medications (like steroids) that suppress the immune system.
People who live with someone who is at greatest risk of adverse effects also should not be vaccinated. These people should not receive the vaccine unless they have been exposed to smallpox.


Q. How many people have been vaccinated so far?

A. Some laboratory technicians, the federal public health response team, and groups in clinical trials related to production of Vaccinia Immun Globulin (VIG-for treatment of severe side effects) have been vaccinated.


Q. When will vaccinations start?

A. According to the current plan, we anticipate that vaccination of public health and hospital response teams may begin in late January.


Q. Can I go to my doctor and get vaccinated against smallpox?

A. No. At this time, vaccine will be distributed on a limited, secure basis to state health departments.


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