Staying the Devouring Monster: Smallpox Vaccine and Bioterror Preparedness - Page 2

This week, the CDC released its smallpox vaccine guidelines for state and local health departments in the event of a bioterrorist attack. The guidelines give detailed instructions and advice for setting up mass vaccination clinics should they be needed. They give guidance on who to quarantine and when. There are patient information sheets about the vaccine and patient questionnaires to be administered before vaccination. What the guidelines don't have are recommendations for educating the average physician on how to respond if he should find a case in his exam room. And what is missing is any suggestions on how to handle the panic that would surely ensue. And, what has been missing for the past year is any attempt to educate the public about the disease or the vaccine so that an informed debate about pre-attack voluntary mass vaccination could take place. The underlying assumption of the CDC has been that the American public is incapable of understanding the risks to themselves and others of mass vaccination.

The smallpox vaccine actually isn't made from the smallpox virus at all, but from the cowpox virus, vaccinia. (Thus the word "vaccine.") Like the smallpox virus, the cowpox virus is a very large and complex viral molecule. It's very close in structure to the smallpox virus; close enough to fool the body's immune system into thinking cowpox and smallpox are the same virus, but different enough not to have the same lethality, or even to naturally infect people. The vaccine is what is called an "attenuated vaccine", which means that it consists of live virus grown over and over in animal cells until it loses its potency without losing its ability to induce immunity. In a way, this is an advantage to us as we prepare to defend against those who would manipulate such things to cause us harm. Because the vaccine is a large virus molecule, produced in a cell culture, it's difficult to guess what part of it would need manipulating to make the smallpox virus capable of escaping the immune system, while maintaining its virulence and lethality. Not impossible, but extremely difficult and unlikely.

The fact that it is a live virus also means that there are more side effects from being vaccinated. A successful vaccination causes a local reaction and scarring at the site of innoculation. It also can cause fever and malaise. Because it is administered by scratching the virus into the skin, the virus can also be picked up and transferred to other parts of the body easily. For example, scratch the site of the injection then rub your eye, and you could get a cowpox infection in your eye. It can also result in a diffuse cowpox rash that is annoying but not fatal.

Article Author: Sydney Smith

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