The needle and the damage undone 

After vaccinating half a million servicemen and women for smallpox, the Pentagon has reached the conclusion that the vaccine is safe. Yet that news hasn’t done much to spur the public to come forward for its shots. In addition to military personnel, the Bush administration had planned on inoculating 10 million civilians. Both nationally and locally, that plan has fallen short.

Ongoing concerns about the vaccine’s safety have led to a less than rousing total of about 40,000 vaccinations administered nationally, and only 130 in Montana.

But the number of vaccinations isn’t the only key to protecting against an outbreak, says Joyce Burgett, who’s in charge of supervising Montana’s smallpox immunization program. The hundred people who have been trained to administer the vaccine are equally important—especially as the flow of citizens volunteering for the vaccination has slowed to a trickle.

“There was a great deal of interest in the beginning, and then as time wore on there was less interest,” says Burgett. “The reality is that it’s not a very safe vaccine. It’s hard to compare this to another time in history, because now we have people who are immune-suppressed living in our communities, and we know their response to this vaccine could be dangerous. So we ran up against some real problems finding volunteers.”

With the search stalled, Burgett says the state is focusing on plans to roll out mass immunizations quickly, should a pressing need arise. The Center for Disease Control director estimates that the test of the president’s plan is whether the entire nation could be vaccinated within 10 days of an outbreak, which is not a present feasibility, nationally or locally.

“It would be a stretch, there’s no doubt about that,” says Burgett. “That’s why we want to work hard to get our mass immunization clinics set up…We’re hoping that we can get people trained as hospital team members who would be in charge of caring for possible smallpox patients who would come into their facility on a 24/7 basis.”

Locally, the City/County Health Department has run into the same problems as the nation and the state—only six Missoulians have been vaccinated, and the department is far from prepared to vaccinate the local population in a 10-day window.

“I don’t have a day count,” says Brant Goode of the City/County Health Department. “But we know about that time frame for doing the vaccinations…It’s a matter of planning and pulling out all the stops to do it.”

Goode says his department is closing in on a plan he believes can keep an outbreak contained, but he’s got other worries as well.

“It is a concern that there may not be enough vaccine available,” he says. Only 16 Montana hospitals stock supplies of the vaccine. “[The federal government] is looking to produce more vaccine, but right now that’s a work in progress.”

Burgett adds that the government is also at work on a new, safer vaccine, in hopes of convincing a skeptical public to follow the president’s instructions to suck it up and take their medicine.

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