Flexibility needed in bioterror response

A public health plan that can apply to an outbreak of SARS as well as to smallpox is the goal, says a new federal report.

By Susan J. Landers, AMNews staff. Sept. 1, 2003.

Washington -- Communities and hospitals should focus on fine-tuning their bioterror response plans rather than on vaccinating large numbers of physicians and other health workers with the sometimes dangerous smallpox vaccine, says a new Institute of Medicine report.

And, given the risks posed by the vaccine, not only to individuals receiving it but to their family members, the general public should only receive the vaccine within the bounds of a research study or other stringent clinical arrangements.

"Preparedness for an attack using smallpox or any other bioterrorist agent depends as much on the availability of a good response plan and the ability to quickly coordinate responders as it does on the number of responders who have been vaccinated in advance," said Brian Strom, MD, MPH, chair of the IOM Committee on Smallpox Vaccination Implementation that prepared the document at the behest of the Centers for Disease Control and Prevention.

The advice is welcomed by some in the public health community who have argued from the start that the risks of a broad vaccination initiative outweigh the benefits. Their views have been strengthened in recent months as evidence of bioterrorist agents in Iraq continues to be elusive.

Meanwhile, there has been a much smaller turnout of civilian volunteers than was anticipated, about 38,000 instead of an estimated 500,000. But the focus shouldn't be on the numbers, said Dr. Strom. "The real question is who needs to be vaccinated."