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December 11, 2002
HONOLULU, HI---The Hawaii Department of Health (DOH), on behalf of
the State, has filed Hawaii's plan for vaccinating public health and
health care response teams against smallpox with the Centers for
Disease Control and Prevention (CDC). The program will include
vaccinating up to 3,500 public health and health care workers
statewide.
Dr. Paul Effler, DOH Communicable Disease Division Chief said, "the
probability of an intentional release of smallpox virus is low, but
because the outcome is so serious, as with any infectious disease we
must be ready to respond. Pre-event vaccination of our response teams
enables them to act swiftly to protect the public, this includes
identifying those that need vaccination to control an outbreak as well
as establishing vaccination clinics.
Each state was asked to submit its plan to CDC by Dec. 9. The
CDC will then review and approve each plan before the vaccination
process can begin. When the Hawaii plan is approved, and the CDC
releases the necessary vaccine, vaccination of healthcare response
teams could begin as early as January 2003.
Only a limited number of public health and health care providers
will be eligible to receive the vaccination, contingent upon the roles
they may play in an outbreak response and whether or not individuals
have any health conditions. Health care and public health providers
with a history of eczema or other skin conditions, pregnancy, or HIV
infection will not be considered for this round of vaccinations. All
participation by public health and health care providers will be on a
voluntary basis.
The Hawaii Department of Health is working closely with the state's
hospitals through the Healthcare Association of Hawaii, and the medical
community to identify and educate potential health care response team
members. Likewise, the Health Department will be drawing the
public health response team members from its own workforce.
CDC has requested that states submit these plans for implementing
what is called "Phase 1" of the National Smallpox Vaccination Program.
At this time the federal government has not yet made a decision to
begin vaccinating anyone, and no vaccine has been issued to the states.
However, the U.S. Dept. of Health and Human Services is considering
"pre-event" vaccination - vaccination that takes place before there is
a confirmed case or outbreak. This pre-event National Smallpox
Vaccination Program could potentially proceed in three phases:
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Phase 1 would offer vaccine to designated health professionals
across the nation who would make up the first public health and medical
response teams. This includes personnel in hospitals who might first
come in contact with an infected patient. It also includes those public
health personnel who would be assigned to investigate cases, track
contacts, vaccinate people, and institute measures to control the
spread of disease.
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Phase 2 would expand the offer of vaccination to all health care and
public safety workers nationally.
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Phase 3 would potentially offer smallpox vaccination to all
Americans at a later date.
The plans currently submitted to CDC address Phase 1. Hawaii's plans
include the creation of readiness teams for each of the counties. These
teams vary in number and size. Each team will have a basic core group
of professionals that will include a Medical Epidemiologist or
Physician, an Epidemiology Specialist, a Microbiologist or Laboratory
Specialist, a Public Health Nurse or Immunization Specialist and a
Paramedical assistant. Hawaii Hospitals are creating virtual teams,
which will include members from various facilities who will come
together during an emergency so as not to exhaust resources at any one
facility.
Hawaii estimates it will need approximately 4,500 doses of vaccine
to cover 3,500 individuals. Identified healthcare workers will be
screened to determine any risk factors and given the option to receive
the vaccine. Vaccination clinics are planned for each of the counties
and vaccine will be administered by trained DOH public health
nurses.
A separate plan, describing how Hawaii would respond to a case of
smallpox, has also been developed by the Hawaii Department of Health
and submitted to the CDC on Dec.1.
The Hawaii Department of Health has received a $9 million dollar
grant from The Centers For Disease Control and Prevention in May of
2002 to conduct a Bioterrorism Preparedness Program. Today the DOH
Bioterrorism Preparedness Program houses close to 35 staff, and works
with local and national institutions to keep abreast of the most
current CDC smallpox vaccination plan news, requirements, and
events.
Information for the public on smallpox is available at the DOH
website at www.state.hi.us/doh
and at the U.S. Centers for Disease Control and Prevention website at
www.cdc.gov
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