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February 19, 2003


Emory Healthcare Begins Smallpox Vaccinations

ATLANTA -- A small number of doctors and nurses in Emory Healthcare will receive smallpox vaccinations as a precautionary measure in accordance with national preparedness plans developed by the U.S. Centers for Disease Control and Prevention.

Dr. David Stephens, Executive Vice Chairman of the Department of Medicine in the Emory University School of Medicine, said that about 10 Emory Healthcare professionals have been vaccinated to date and up to 10 more may be vaccinated in coming weeks in the initial response to the potential threat of bioterrorism and associated recommendations issued by the Advisory Committee on Immunization Practices.

Leaders of Emory Healthcare, including Dr. Stephens, Dr. Jeffrey Koplan, vice president for academic health affairs, and hospital epidemiologists from Emory University Hospital and Emory Crawford Long Hospital, decided on Emory Healthcare's limited vaccination strategy after carefully weighing known risks and potential benefits.

Although the Emory University Hospitals were not included in Georgia's plans for the first phase of smallpox vaccination, Emory physicians might be called on to treat several categories of persons infected by smallpox or vaccinia, according to Dr. Stephens. Those persons could include researchers and employees at the CDC; Emory's own researchers working on vaccinia or related viruses; and Emory Hospitals doctors treating military-related cases of smallpox or vaccinia.

Weighing against widespread vaccination, on the other hand, are the known risks of smallpox vaccination for persons who suffer from eczema or have suppressed immune systems from chemotherapy or conditions such as HIV/AIDS. The vaccinia virus that is used to induce immunity to smallpox is also contagious by touch. The Emory guidelines state that doctors and nurses who are immunized will be precluded from working with immuno-compromised patients until the period of contagion passes, up to 21 days when the vaccination scar separates from the skin.

Emory employees who are vaccinated, whether at Emory or elsewhere, will be required to notify the respective Infection Control Department at Emory University Hospital or Emory Crawford Long Hospital. Infection control specialists will confer with their supervisors and evaluate the employees' work situations to make sure that patient safety is protected during the time it takes for the vaccination scar to heal. Safety measures will include wearing semi-permeable dressings on the vaccination site, long sleeves, and careful adherence to hand hygiene.

The approximately 10 infectious disease specialists, nurse practitioners and laboratory researchers who have been vaccinated at Emory are all volunteers. Persons with previous immunizations, even if they were given decades ago as children, seem to be less likely to suffer severe adverse reactions.

"We believe this is the most responsible course of action to protect our own employees and patients, while still preparing for what we hope is the distant prospect of smallpox bioterrorism," said Dr. Koplan. "If there is any documented case of smallpox anywhere in the world, we do have a supply of smallpox vaccine on hand and we have the ability to immunize many more Emory Healthcare workers rapidly. We continue to reevaluate the relative risks and benefits of smallpox vaccination in consultation with experts on our faculty and at CDC and with colleagues at the Georgia Department of Health."

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