Audio Midday discusses Minnesota's plans for dealing with smallpox Photos Ramsey County Public Health official Jane Norbin Rob Fulton, Ramsey County's public health director Ramsey County health care workers asked questions about the vaccination plans More from MPR Questions about quarantine and smallpox (11/26/2001) Resources Minnesota Department of Health U.S. Department of Health and Human Services CDC -- information on smallpox and vaccinations Respond to this story Talk about this story in the MPR News Forum Submit a commentary Help us cover this story

Health officials ponder smallpox plans
by Tom Scheck, Minnesota Public Radio
December 12, 2002

Ramsey County Public Health official Jane Norbin talks to county health care workers Thursday about smallpox vaccinations. (MPR Photo/Tom Scheck)

Minnesota's public health agencies are preparing to move forward with a vaccination plan for smallpox. President Bush is reportedly set to announce Friday that he'll order mandatory vaccinations for the military, and voluntary vaccinations for front line health workers, to begin in the next month. Other health care workers, police and fire will be next in line to receive the vaccine, followed by the general public. State and county public health agencies have been going through their plans and are holding meetings to explain the details to workers.

St. Paul, Minn. — The last confirmed case of smallpox was in 1977 in Africa. In 1980, the World Health Organization recommended that countries cease vaccination and destroy their stocks of the virus. But recently, fears have grown that some rogue nations and terrorist organizations have acquired smallpox and are willing to use it in a terrorist act.

Smallpox is contagious, hard to detect and kills one-third of the people who contract the disease. President Bush is reportedly releasing the vaccine so the nation's health care workers can treat others for possible exposure. Kris Ehresmann with the Minnesota Health Department says the state is waiting for the Bush administration to set the timelines for immunization.

"Before we can make a definitive statement about how the plan will be rolling out, we do need that time frame," says Ehresmann. "But on the other hand, this is a very ambitious project and so we're really not waiting. We're going ahead with planning."

	Rob Fulton, Ramsey County's public health director

Ehresmann says the state plan is setting up nine districts to administer the vaccine. Up to 10,000 people will be vaccinated in phase one. Phase two, which will immunize medical personnel, emergency workers and others, covers another 250,000 people. There will be one centralized site that will both accept and store the vaccine.

Ehresmann says county and state agencies will hold meetings with public health workers to talk about smallpox, the vaccination and any perceived dangers. Ramsey County officials held the first such meeting Thursday at the Fairview Community Center.

Jane Norbin, Ramsey County's director of Health Policy and Planning, told the group that they need to reflect individually on whether or not they want to receive the vaccine and be on the front lines if there's a smallpox outbreak.

"I hope this goes the way of the fallout shelters, and we do a lot of work but we don't ever use it. But you need to think about it. If the call comes and we need you at work, will you go?" Norbin says. Rob Fulton, Ramsey County's public health director, says the state will immunize state and county public health nurses first so they can give the vaccination to hospital personnnel and others. He says 35 of Ramsey County's 70 public health nurses have agreed to receive the vaccination. Nurses who don't have the vaccine aren't allowed to vaccinate others.

	Ramsey County health care workers asked questions about the vaccination plans

"These are the folks who will be asked to start giving the vaccinations -- or start supporting the folks who are giving the vaccinations -- and will be doing it in one of our sites. We wanted people to have as much knowledge and information as possible," says Fulton.

While many workers say it's their role as public health officials to get the vaccination, some expressed concern. There were questions about the timing of the vaccination plan and possible side effects. One worker, who declined to give her name, said she's concerned about statistics that say up to 50 people out of one million will experience life-threatening complications from the vaccine. One in a million die from those complications.

"I had trouble making those decisions for my son when he was a baby -- to think that he could have some real severe reactions -- so I have those concerns for myself and co-workers in the public health arena. We'll be getting these vaccines ... and I wonder if there's been additional testing to be sure that it's safe?" she asks.

Diane O'Connor with the Minnesota Nurses Association says the union wants to make sure its members have the option of refusing the vaccine, that they receive additional training on how to administer the vaccine and that appropriate safety measures are taken. A large part of the union's membership could be eligible for the vaccine in the first two phases of vaccine delivery since they work in hospitals and clinics.

"This situation we're facing is a little different from past situations, and so I think there are a lot more questions in their minds. Just the very nature of the threat that we face is vague and at the same time it's kind of frightening," says O'Connor.

Officials say the general public will have the option to receive the vaccine after the nation's health care workforce, military and emergency personnel get the vaccine. However, mass public vaccinations wouldn't begin until 2004.

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