IAFC Smallpox Vaccination Working Group Formed

Fairfax, VA – President Bush is expected to announce a multi-phase program for resuming smallpox vaccination in the United States as a protective measure in the event of a terrorist attack using the smallpox virus. The measure, which has been widely reported in recent months, could potentially impact all first responders across the nation and will undoubtedly become an issue for fire and emergency services departments everywhere, regardless of their type, location or community size.

In anticipation of this announcement, the IAFC has built upon its prior efforts on this serious issue in establishing a new “Smallpox Vaccination Working Group” which convened for the first time Dec. 6-7, 2002 in Washington, D.C. The purpose in forming the group was to assemble a number of EMS, Hazmat and Terrorism specialists from within the fire service to interface with the various federal agencies in addressing critical issues involved in making the vaccine available to fire service personnel.

Following the President’s official approval of the measure tomorrow, it is expected that the new smallpox vaccination program will be rolled out in two initial phases as follows:

• PHASE I will make the vaccine available, on a voluntary basis, to approximately 500,000 local public health officials, epidemiologists and hospital workers who are designated to serve as the primary investigators in the event of a smallpox outbreak. It is expected that the phase I vaccinations will be completed within 30-60 days after the President’s announcement.
• PHASE II of the vaccination program is expected to make the vaccine available, on a voluntary basis, to additional health care workers and fire, police and EMS “first responders.” It is expected that in this phase the vaccine will be made available to up to ten million people.
  
  In the event that a member of the Phase II vaccination group comes into contact with an actual smallpox patient prior to vaccination, they would be quickly identified by the investigative team and vaccinated after exposure. Unlike most trauma and chemical events, use of most biologic weapons, including smallpox, entails an incubation period. Smallpox vaccination has been shown to be extremely effective at preventing smallpox if given within 4-5 days of exposure. All contacts of a known case that have been identified, including any Fire, EMS or public safety personnel, would be vaccinated to prevent the development of smallpox.

One of the primary issues of concern over the President’s proposed plan involves the matter of the smallpox vaccine itself. Because of the nature of this live-virus vaccine, the smallpox vaccine has much higher levels of side effects associated with it compared to most modern vaccines. In addition, the vaccine site is contagious for a period of time after vaccination and represents a potential hazard to those that come into close contact with the vaccinated individual.

During the first meeting of the new IAFC working group, immediate steps were taken in an effort to address such concerns from the perspective of the first responder community. As a result, the working group identified three key issues and assigned the following actions:

1. A list of questions was developed that will be sent to the Department of Health and Human Services (DHHS) which identifies several unique characteristics of the fire service that could complicate a smallpox vaccination program;
2. A motion to the IAFC Board of Directors to consider revisions to the IAFC policy on smallpox vaccination for the fire service that will be submitted for consideration at the upcoming meeting January 23-24; and
3. The identification of key topics to be covered in an upcoming IAFC publication (“white paper”) that will provide fire chiefs with a reference guide on smallpox vaccination with an emphasis on administrative issues.

The new IAFC Smallpox Vaccination Working Group is comprised of the following individuals:

• Richard Brooks, Captain, Baltimore County (MD) Fire Department (IAFC HazMat Committee)
• David Fischler, Commissioner, Suffolk County (NY) Fire and Rescue (IAFC Terrorism Committee)
• Jack Krakeel, Chief, Fayette County (GA) Fire and Emergency Services (IAFC EMS Section Representative to the Board of Directors)
• Russ McCallion, Section Chief, EMS, San Francisco Fire Department (IAFC EMS Section)
• John Sinclair, Deputy Chief, Central Pierce (WA) Fire and Rescue (IAFC EMS Section)
• Dr. Michael Brackett, District Health Director; Lagrange, Georgia

Please watch for subsequent updates and additional information on this important issue which will be provided by the working group both as “IAFC Member Alerts” and publications.

For immediate reference on this subject, please visit the CDC/DHHS website at http://www.bt.cdc.gov/DocumentsApp/Smallpox/RPG/index.asp or see the 2001 CDC Smallpox Preliminary Vaccination Recommendations at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5010a1.htm.