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Israel gives smallpox vaccines -- should U.S.?

From Elizabeth Cohen
CNN

Health care workers and rescuers are the first Israelis to receive the smallpox vaccine.
Health care workers and rescuers are the first Israelis to receive the smallpox vaccine.

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CNN's Elizabeth Cohen takes a look at Israel's smallpox vaccination program as the United States debates such a move. (November 20)
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(CNN) -- For the past year, the U.S. government and health officials have been debating whether Americans should be vaccinated against the smallpox virus. Meanwhile, Israel is already doing it.

In just three months, the Israeli government has gone from making the decision to nearly completing the task of vaccinating 15,000 health workers, police officers and others that would likely be first on the scene in the event of a smallpox outbreak.

And the United States is watching closely, because this is one dangerous vaccine.

"The authorities have tremendous interest in what's going on, in what our experiences are," said Dr. Boaz Lev, director of the Israeli Health Ministry. And the experience has been good, according to the ministry.

No serious side effects even though the vaccine in the past has killed people. That has bolstered the argument for vaccinating U.S. health care workers and then the population as soon as possible.

"Serious complications and deaths are going to be extremely rare and as we've seen in the case of Israel, at the present time, it sounds like zero," said Dr. Bill Bickness of the Boston University School of Public Health.

Statistically speaking, the smallpox vaccine kills one in a million people and causes encephalitis -- swelling of the brain -- in one in 300,000.

Bickness and others are trying to convince President Bush that the side effects will be far fewer than predicted as long as health officials do what the Israelis have done -- weed out people who shouldn't get the vaccine, such as those with certain medical conditions.

Also, if the vaccine does make people sick, there's a treatment for some of the side effects. It's called vaccinia immune globulin and it's made from the blood of people who've already been vaccinated.

Other experts are urging the president not to vaccinate anyone unless there's an actual smallpox attack. They say Israel's experience might be good, but it's too small to draw any conclusions.

Dr. Carlos del Rio, an infectious disease specialist at Emory University in Atlanta, is among the skeptics. "I would really worry about vaccinating people and having to live with the consequences of vaccination and the complications of vaccinations," he said.

Del Rio adds it's not just the vaccinated person who's at risk. Anyone who touches the site on a recently vaccinated person's skin could also get sick.

"I can tell you that, you know, somebody's patch is going to fall off. And something is going to happen," said del Rio.

These are the very issues the president and his advisers are debating. A decision about who should get the smallpox vaccine -- and when -- is expected in the next few weeks.



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