NO real protection/screening during smallpox vaccination will be enforced

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http://forums.delphiforums.com/medical/messages?msg=33330.1

The nation's largest union representing health care workers said

Wednesday that various protections are needed for nurses and others

set to receive smallpox vaccinations three decades after the United

States stopped using the vaccine.

Officials with the Service Employees International Union met with top

Bush administration officials Wednesday, seeking assurances that

workers who get sick from the vaccine can take time off and that

people offered the vaccine will be properly screened for a variety of

conditions first.

" Without better protections, the proposed plan could put hospital

patients, caregivers and the public at risk, " the union, which

represents 710,000 medical workers, said in a statement.

Jerry Hauer, the top bioterrorism official at the Department of

Health and Human Services, said the federal government shares many of

their concerns. But he added that some of the questions fall outside

the government's power to address.

" Many, not all, of the issues they talked with us about are things we

have been very aware of and have been working on or have addressed, "

said Hauer, who attended Wednesday's meeting.

In the coming days, the administration is expected to announce its

plan for resuming smallpox vaccinations, part of the effort to

prepare for a possible bioterror attack with the virus. The disease

was declared eradicated in 1980, but experts now fear it could be

intentionally released by terrorists or a hostile nation like Iraq.

Sick patients cannot be cured, and about 30 percent of those infected

will die.

But the vaccine itself is risky, too. Based on studies from the

1960s, experts estimate that one or two out of every 1 million people

getting the vaccine for the first time will die, and about 15 will

face life-threatening injuries.

Officials say the Bush plan will offer the vaccine in stages,

beginning with those most likely to encounter a contagious patient,

including those who would be needed to help investigate suspicious

smallpox cases and those who would vaccinate others if the disease

were to return.

Health care workers are at the top of the list. Under the plan,

during the first stage of vaccinations, the shots would be offered to

people who work in hospital emergency rooms, and the second stage

would cover all other health care workers.

The plan has advocates for nurses and other medical workers demanding

assurances that they will be protected. Among their concerns:

_Time off: Some people who receive the vaccine will feel sick

afterward, and the union wants to be sure they can take time off with

pay. Hauer said hospital administrators will have to address this

because the government cannot require that workers be given time off.

Another concern is that if the inoculation site is not properly

sealed, the live virus in the vaccine could escape and,

theoretically, infect patients, injuring them. Advisers to the

Centers for Disease Control and Prevention say that, as long as

proper bandages are used, there's no reason nurses and others can't

go to work.

(((so, they can perform procedures on the sick patients with

contagiously infected arms!!!!))

_Compensation: Congress has shielded people and institutions who give

vaccines from legal liability if patients are injured or killed,

partly an effort to protect nurses who will be giving the shots.

Injured parties will only be able to sue the federal government in

federal court for damages. But the union says victims need a simpler

and fairer compensation system, such as an existing fund established

to compensate people injured by other vaccines.

Hauer said the issue was being examined but made no commitments.

_Screening: People who have compromised immune systems face

particular risk and should not get the vaccine absent a certain risk

of infection. That includes people with HIV, the virus that causes

AIDS, but many who have HIV don't know it. The union wants

confidential HIV tests available on the spot.

Hauer said the federal government does not plan to mandate that tests

be available, but he expects that most states will have them for

those who want the test.

((my comment: what about pregnancy tests? and who pays for those?))

_Right to say no: The federal plan will be entirely voluntary, but

the union wants to be sure that workers can decline the vaccine

without suffering any discrimination at work.

The administration's plan for vaccinations was expected by the end of

September, but has yet to be officially unveiled.

http://forums.delphiforums.com/medical/messages?msg=33235.1

Union won't oppose smallpox plan

WASHINGTON (CNN) --Representatives of the nation's largest union of

health care workers Wednesday said they will not oppose a government

plan to vaccinate medical workers for smallpox, although they still

have serious safety concerns about it.

The announcement came after meeting with top federal health

officials. President Bush is prepared to announce in coming days the

first large-scale smallpox vaccinations in more than two decades -- a

controversial plan because the vaccine can bring side effects --

including, in rare cases, death.

" The meeting was productive, positive and continuing, " a spokesman

for the U.S. Department of Health and Human Services said.

Under the plan, about 500,000 health care workers will get the

smallpox vaccination, followed up by a second wave of vaccinations

for 7 million to 10 million other health workers, firefighters,

police and first responders, according to a top government official.

Stern, the president of the Service Employees International

Union, which represents 1.5 million health care workers, said union

members will be encouraged to take the vaccine.

However, he listed several issues of concern:

• What if a worker gets sick from the vaccine, needs to be

hospitalized and has no health insurance, or has a $1,000 deductible?

Who pays the bill?

• What if a worker gets vaccinated and his child touches the

vaccination site and falls ill? Who picks up the cost?

• Who pays for screening tests?

" It's clear they [health officials] understand the risks involved

here, " Stern said. " But there's no plan to pay for them, except to

hope that people's insurance, or the people themselves, will be able

to pay for it. "

He added that the government has not " dealt with real life issues " in

its planning.

However, government officials have said that is not true, that the

administration has spent more than a year consulting health officials

across the globe and agonizing over whether to vaccinate people.

" Issues raised by Stern are issues we have been thinking about

since the very beginning, " the HHS spokesman said.

The health risks

According to health officials, one or two people out of every million

who get the vaccine will die from it.

" At the end of the day, people will die, " one official said.

An additional 15 people per million vaccinated for the first time

will suffer life-threatening complications. Scores more will fall

sick with fevers and swollen lymph nodes.

The Centers for Disease Control and Prevention says many people --

including pregnant women and those with weakened immune systems, such

as HIV patients and some people with cancer -- should not be given

the vaccine.

Under Bush's vaccination plan, according to one health official, the

vaccine will be made available to the public, but only through

clinical trials, and the government would not recommend that anyone

besides health workers and first responders take the vaccine.