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CNN Live Today

Smallpox Terror Decision Due

Aired September 04, 2002 - 11:26   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


DARYN KAGAN, CNN ANCHOR: A decision is expected soon from President Bush on how many Americans should be vaccinated against smallpox. The disease has been wiped out, of course, but there are new concerns that it could be unleashed again in a biological attack.
We get the latest now from our medical correspondent, Dr. Sanjay Gupta.

(BEGIN VIDEOTAPE)

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT (voice-over): Americans haven't been vaccinated for smallpox since 1972. But that may soon change.

TOMMY THOMPSON, HEALTH AND HUMAN SERVICES SECRETARY: It's into the White House right now. And the White House is reviewing my recommendations. And, hopefully, we'll have a decision in the near future.

GUPTA: Although triumphantly eradicated from the world in 1979, experts are concerned smallpox could show up again, this time as a weapon of bioterrorism.

SEN. BILL FRIST (R), TENNESSEE: I would say that the risk of a smallpox attack is very real. I would say that that risk is increasing, compared to, say, five or 10 years ago. And I would say, as a nation, that we do remain highly vulnerable if smallpox is used as an instrument of war.

GUPTA: Highly vulnerable, because if you are under 32, you probably haven't been vaccinated. And if you're older and did receive the shot, it's questionable how much protection you still have.

FRIST: Every American should have the opportunity to make an informed individual choice, to evaluate those risks, plus those benefits, to receive that smallpox vaccine.

GUPTA: It's weighing the risks and the benefits that makes this vaccine so complicated.

BELSHE: There's a lot of people that should not be vaccinated with smallpox vaccine.

GUPTA: Dr. Robert Belshe of St. Louis University has worked on several smallpox vaccine trials.

BELSHE: The logistics of conducting a large-scale vaccination program, if we're talking on the order of millions, would be enormously complex.

GUPTA: And the vaccination itself could cost serious side- effects.

DR. D.A. HENDERSON, HEALTH AND HUMAN SERVICES: The persons most at risk are those who have a serious skin condition of eczema, people who are being treated for cancer, people who are getting organ transplantation, people who have a severe HIV disease.

GUPTA: That's because their immune system is more susceptible to the live virus in the vaccine. They're so susceptible, they could even catch a variety of the disease from someone who has been recently vaccinated.

(on camera): And sometimes, people will die. Remember New York 1947, a smallpox outbreak. Six million people were vaccinated. Two died from the disease and eight from vaccination side-effects. Experts warn that the numbers could even be higher today due to the increase in eczema, HIV and even cancer.

HENDERSON: We would estimate maybe two to four deaths per million might be more likely today.

GUPTA (voice-over): If everyone in the country were vaccinated, the death toll could approach 1,000. That's still better than the death toll in previous outbreaks with no vaccinations. Then, 16 to 30 percent of those infected died. It's a great medical debate: to vaccinate or not to vaccinate? Soon we may all have to decide.

(END VIDEOTAPE)

GUPTA: And to be clear, there are now 160 million doses of vaccine available. By the end of next year, the end of 2003, there should be 300 million, enough to vaccinate every single citizen in the United States. But to vaccinate or not to vaccinate, that's a question we are all going to have answer for ourselves.

KAGAN: A couple of things are different. One thing with this virus, it's a live virus, and that's why it's so dangerous.

GUPTA: That's right. And it's different than a lot of the other virus -- a lot of the other inoculations that kids get. A live virus, this can cause real problems, and I think this is part of the debate that people are having. If everyone got inoculated, got vaccinated, for smallpox, up to 1,000 people could die, not to mention a lot of people actually getting the permanently disfiguring scars...

KAGAN: Yes.

GUPTA: ... that have become so commonly associated with smallpox.

KAGAN: Speaking of scars, little scars, those of us who did get vaccinated for smallpox, you either look at your arm or your hip or wherever you got it, and you think, oh, I got that shot...

GUPTA: That's right.

KAGAN: ... when I was a kid. And then, you're wondering, well, am I covered?

GUPTA: That's right.

KAGAN: Am I not?

GUPTA: So it's kind of gone back and forth. A lot of -- everyone said, oh, I got the shot, I'm covered. And then, the convention wisdom was, you know what? That shot probably still doesn't last today. It's been 30 years. It probably still doesn't last.

And now, we're sort of going back again, saying, we've checked those people, people who have had shots over 35 years ago, and find that, in fact, they do have a significant amount of immunity. Still, the question is: Is it enough? And nobody can really answer that question -- Daryn.

KAGAN: So we're waiting to hear from the president and what they decide in the administration. But ultimately, this will be an individual choice, won't it?

GUPTA: That's right. I don't think anyone is talking about mandatory vaccinations. And it's going to be -- it is an interesting problem, because even if you decide not to get the vaccination but someone at your workplace decides to get the vaccination -- and it's potentially contagious for some time -- that's going to affect you, even if you're someone who decided not to get the vaccination in the first place.

So a lot of different things to weigh in here. It's a really fascinating medical debate, and I'm not sure how it's all going to play out. But I bet you it's going to end up being voluntary vaccinations for people.

KAGAN: We'll be watching it.

GUPTA: Yes.

KAGAN: And so will you. Dr. Sanjay Gupta, thank you.

GUPTA: Thank you.

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