Smallpox Vaccine - my husband is military

[etwahl]

I've been watching cnn all morning on the smallpox debate. Actually they read and answered an email I sent them just this morning!

I'm just curious what others opinions are regarding this. DH is supposed to get it within a couple weeks, however, based on what I've heard today, he should refuse it (they can't make it mandatory, can they?)

The reasons for us are two-fold. One, I've suffered from eczema my whole life, and two, being pregnant.

Just wondering what others reactions/thoughts are regarding this issue. It's definitely a concern for me. By the way, apparently I had the vaccine as a young child (I'm only 30, but in Canada I guess they still gave it -- I have the big scar on my arm to prove it) but I don't know if I had side effects then, although I have heard the vaccine doesn't last that long anyway.

Tammy,
Mom-to-be Mar 8, 2003!

[Rachels]

Part of the problem is that no one is sure how long the vaccine lasts. You're right that you shouldn't get it-- eczema and pregnancy are rule-outs. I don't know what the risks are for you if your husband gets it, but I would be VERY careful to ask that question of a number of doctors first. It's a live vaccine, which is why it's potentially so dangerous. So they inject a little bit of smallpox, and my guess is that you shouldn't be anywhere near that. There is talk of making it mandatory for military personnel, but I don't know if you could get an exemption if your husband being vaccinated would put you at risk. I wish I knew the answer. But I'd start making calls!

-Rachel
Mom to Abigail Rose
5/18/02

[megsmom]

The vaccine discussion resurfaces under a different thread! :)

I too have suffered ezcema my whole life. I also would like to become pregnant in the 2003. So, in short, nobody is coming near me with a smallpox vaccine! I just heard yesterday that some of our hospital personnel may have to be vaccinated. What does this mean for us innocent folks walking about in the hallways?

Better go log into CNN.

Jen
mom to Meghan
born 7/13/01

[Rachels]

Here's a link to an article about who should NOT get the vaccine. It talks about pregnancy as one rule-out, but also says that people who live with vulnerable people shouldn't get it. So if you're pregnant, your housemates shouldn't be vaccinated. It also says it's mandatory for the military, but again, I'd find out as much as possible about how to get out of that since your husband being innoculated would put you at risk. Anyway, here's the link:

http//:www.iwon.com/home/health/health_article/0,11720,510834|12-14-2002::06:00,00.html

-Rachel
Mom to Abigail Rose
5/18/02

EDIT: Rats. Can't make the link work. Here's the text of the article:

Smallpox Vaccine Not for Everyone
Bush, but not his family, will get it, and experts say many others shouldn't also

By Randy Dotinga
HealthScoutNews Reporter
FRIDAY, Dec. 13 (HealthScoutNews) -- Have you ever had a rash in the crease of your elbow or behind your knee? Even if it was decades ago, that could be enough to knock you off the list of Americans eligible to get the smallpox vaccine.

Plenty of other people may find themselves exempt too -- pregnant women, patients undergoing chemotherapy, organ transplant recipients and AIDS patients.

The list goes on and on -- all the way to Americans who live with vulnerable people. They shouldn't get the smallpox vaccine either for fear they'll infect their housemates.

As expected, President Bush announced the nation's smallpox vaccination plan today, saying that the jabs will be mandatory for the military and that health-care workers will be next. For the rest of the country, however, the inoculations will be voluntary because, he said, the threat of a smallpox attack by terrorists isn't imminent and the vaccine carries risks.

At a White House briefing, Bush said he personally would get the vaccination.

"As commander in chief [of the armed forces], I do not believe I can ask others to take this risk unless I do the same," he said.

But the White House will first have to determine whether others living and working there are vulnerable, because Bush also said that neither his family nor his staff will be inoculated.

"Our health and national security experts do not believe a vaccination is necessary for the general public," Bush said.

Experts also say a substantial number of Americans should avoid the vaccine.

"An estimated 20 to 40 percent of the population should not be vaccinated," said Dr. Steve Black, director of the Kaiser Permanente Vaccine Study Center in Oakland, Calif.

But it won't be easy figuring out who must avoid the vaccine.

Perhaps the most unusual vaccine risk factor is a history of the skin disease known as eczema. The infection can strike at any age, causing a rash that usually can't be cured without the use of a prescription cream. The infection commonly strikes creases in the skin, such the inside of the elbow and the back of the knee.

Researchers don't know what causes eczema and a sister disease, atopic dermatitis, which is also a vaccine risk factor. But it is clear that people who have had eczema may be left with skin that's especially susceptible to the virus that is in the vaccine.

"Their skin doesn't operate the way other people's skin does," Black said, "even though there's no visible difference."

People who get the smallpox vaccine become infected with a dime-sized pustule on their upper arms. If all goes well, the pustule -- an infection with a virus similar to smallpox but much less dangerous -- will heal and leave the body primed to fight smallpox.

In people who have had eczema, however, the virus can spread across the skin to other parts of the body, said Dr. Corry Dekker, medical director of a children's hospital at Stanford University.

"Under the current circumstances, when there hasn't been any release of smallpox, those people would be best served by sitting tight and not getting vaccinated now," Dekker added.

The challenge will be to figure out who's had eczema. "As many as 8 percent -- or more -- of children may get an infection. It's a rash that could come and go through childhood and then be quiet for the rest of a person's life," Dekker said.

But even dormant eczema can make the smallpox vaccine more dangerous than usual.

Other vaccine risk factors are harder to miss. The virus in the vaccine could get out of control in anyone with a compromised immune system, so AIDS patients and those taking immunosuppressive drugs -- like organ transplant and lupus patients -- can't take the vaccine. Some asthma patients may be at risk too because of the drugs they take, Black said.

In patients with weakened immune systems, the pustule wouldn't heal, he said. "It would get larger and spread all over their body on the surface and also inside as well. These people get really quite ill."

The virus caused by the vaccine is also contagious, and Black said people who live with members of risk groups shouldn't take it.

These various challenges are unavoidable, he said, especially considering that the smallpox vaccine is not a modern invention.

"It's been purified more and comes in a prettier bottle, but it's the same vaccine used 200 years ago. We're used to medicine with more sophistication, a kinder, gentler approach to prevention," Black added.

What To Do

For more on the smallpox vaccine, go to Stanford University or the Centers for Disease Control and Prevention.

[etwahl]

Thanks for the article Rachel. I definitely knew I wouldn't want the shot, but also just wanted more clarification whether DH should get it. Based on all the research we've done, we know he definitely should not get it. Thanks again!

Tammy,
Mom-to-be Mar 8, 2003!