Return to Transcripts main page

CNN Live Today

How Will Washington Prepare Nation for Smallpox Attacks?

Aired December 05, 2002 - 11:26   ET

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

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


LEON HARRIS, CNN ANCHOR: The Bush administration is still mulling over whether to go with smallpox vaccinations for health care workers. It would be the first large scale inoculation in more than 20 years and the fear is that the Iraqi President Saddam Hussein has stockpiled the virus and may use it against the United States. The controversy involves the dangerous side effects this vaccine can bring, including in some cases death.
So, what happens if Washington does put a plan in motion? Our medical news correspondent Dr. Sanjay Gupta is standing by with us in New York. Joining me here Jeffrey Koplan of Emory University. And thanks for coming in and taking time to talk with us today about this. We were just chatting off camera, Sanjay, about the smallpox issue, and you've had quite a bit of experience with this.

JEFFREY KOPLAN, EMORY UNIVERSITY: I have.

HARRIS: Would you get the vaccine yourself?

KOPLAN: I don't feel I need it right now, based on what I do and what I know.

HARRIS: What's that mean?

KOPLAN: I'm working in a medical center, working with researchers, working with students, working with teachers. See patients occasionally. But I don't feel that the risk to me at the moment is particularly profound, and thus I don't need the vaccine. It's a good vaccine if there's a risk, but it's what is that risk.

HARRIS: Well, let's talk about that now. Sanjay, we've got quite a few e-mails. Let's toss the first one to you. We've got phone calls also coming in as well. The first e-mail we have here is from Jennifer Pace (ph) in Tallahassee, Florida. How long do small pox vaccines last?

SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Well, that's a good question. I saw that there were a lot of questions sort of along those lines. And the real answer, and unfortunately the real answer to a lot of these questions, is we're not exactly sure how long the small pox vaccine actually lasts.

There was a study recently done out of the University of North Carolina. Leon, you and I talked about this. Basically, what it showed that people who had been vaccinated before '72, who were 30 years or older, probably do have some protection, compared to people who have never been vaccinated. But whether it's enough protection, whether it's enough protection to actually protect you against the smallpox virus, if it existed today, that's hard to say. So we don't really know how long it lasts, although there may be a little more protection in those who have had the vaccine before.

HARRIS: OK. Let's go to the phones now. Cliff (ph) is on the line right now. Cliff (ph), are you there.

CALLER: Yes, I am.

HARRIS: Good morning. What's your question?

CALLER: Good morning. My question is that I was vaccinated twice in the past, once as a kid in grade school, and the other time, I believe, was when I shipped off to Vietnam. Both occasions, I had no complications. And if I took them now, at this time, would I be just as least unlikely to have complications this time around? And would I still be covered from the past vaccines?

HARRIS: That's a good question. Dr. Koplan, what do you think?

KOPLAN: There are a range of complications, and the people most susceptible to those complications are people who are getting the vaccine for the very first time, what are called primary vaccinations. A person who just called up has clearly had it a couple of times before, would be at lesser risk, but there are still some complications that anyone be would prey to, including what's called contact vaccination, where you rub the arm that's been vaccinated or somehow touch it, and then spread it somewhere else, either on yourself or on someone else.

HARRIS: Let's get back to the e-mails here. We have one from Nicole (ph) in New York. Either one of you can jump in on this one. What about the liability if someone dies?

GUPTA: I'm happy to take a stab at that. In fact, you know, I sort of made my way through some of the homeland security bill, Leon, that we've been hearing so much about. And in that homeland security bill are a few clauses about this very issue: The liability to the doctors, to the people who actually give the shots, the people who make the vaccine and to the federal government regarding the liability if someone is -- dies or is injured seriously by this vaccine.

In a nutshell, and Dr. Koplan can jump in as well, but doctors and the people who administer the shots seem to be pretty protected against lawsuits. They're indemnified is the word that they use, protected against lawsuits. The federal government is not. The vaccine makers do have partial protection, although they are contract employees of the federal government, so they're not necessarily fully protected as well. And Leon, I should point out, Dr. Koplan, who is probably one of only a handful of the doctors in the country who has actually treated anybody with small pox in this country may have some other comments about that as well.

KOPLAN: I think that Dr. Gupta has described the legal issues well. There is concern about those. But in my talk with many of our doctors at Emory's Health Science Center, the concern of all the doctors there is the welfare of the patient population and in the community at large. And in every major medical center today, there are very large numbers of people around who have poor immune systems, either because of a disease they have, like HIV or AIDS, or because they're being treated with chemotherapeutic agents that suppresses their immune system. These people are at tremendously greater risk from this virus circulating around. And one of the reasons there is reticence and reluctance on the part of a lot of our staff to have themselves vaccinated has nothing to do with themselves, their own health, or the legal issues. It involves the health of their patients.

HARRIS: That makes sense.

Let's go to the phones now, Judith (ph) is on the phone from Florida. Judith (ph), good morning.

CALLER: Good morning.

HARRIS: What's your question.

CALLER: I'm calling to ask about eczema. We understand you're not supposed to take the small pox vaccine if you have eczema. But I'm curious, if you have eczema in a very mild way, that is just periodic and it goes away, it has small patches, very little of it, and goes away with topic or cortisone treatment, if that should preclude you from getting the vaccine?

KOPLAN: Absolutely. Do not get the vaccine. And you stay away from people who have been vaccinated. The complications of what's called eczema vaccinatum, it's the spread of this virus across people who have eczema or atopic dermatitis, another term for that, is quite severe and it is not worth any risks to you to get this vaccine or to be near people who have had the vaccine.

HARRIS: Well, how do you handle that if you live with someone who's got eczema?

KOPLAN: Then you think twice before you get the vaccine. First of all, the vaccine is not being advocated for the population at large, so this is not a decision that people ought to be spending a lot of time about. If you're worried about vaccinations and you have children, you ought to make sure your children are vaccinated for things that there really are diseases around for, polio, DTP, measles, mumps, rubella, et cetera. If you're older, get the flu vaccine or get the pneumococcal vaccine. But don't spend all your time worrying about a vaccine for a disease that's been eradicated for 30 years.

HARRIS: Sanjay, one final comment on that?

GUPTA: You know, it's an interesting point. The eczema thing has been sort of very confusing as well. Just, I've been doing a little bit of research and reporting on this. Basically, eczema disrupts a lot of what are known as the mucosal surfaces in the body, as well as the skin. So if you've ever had eczema or if you have eczema now and then you get the small pox vaccine, you're at a little bit more risk of this vaccine actually further disrupting those areas. Just as Dr. Koplan said, this eczema vaccinatum, you've seen the pictures, Leon, they're pretty horrific, these ugly, disfiguring lesions and scars all over the body, even worse with people who have had eczema, a real problem in those patients, as Dr. Koplan said. There's about 28 to 30 million people out there who have either ever had eczema or have it now, that just should not get this vaccine.

HARRIS: I think the last time I saw shots of that stuff, it was like in a "National Geographic." That's really, really ugly stuff.

Dr. Sanjay Gupta in New York, we're going to move on, because we've got a lot of news to cram in this hour. We thank folks for calling in and then sending us all the e-mails. Don't worry, we're going to get to some more of this next week. We'll talk some more about it.

Dr. Jeffrey Koplan, not just of Emory University, I've also just been told, formerly of the CDC. Glad to have you in and appreciate your sharing the expertise with us this morning.

KOPLAN: Nice to be back here with you, thanks.

HARRIS: Thanks. We'll have to have you back. OK? Take care.

KOPLAN: Thank you.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com







Aired December 5, 2002 - 11:26   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
LEON HARRIS, CNN ANCHOR: The Bush administration is still mulling over whether to go with smallpox vaccinations for health care workers. It would be the first large scale inoculation in more than 20 years and the fear is that the Iraqi President Saddam Hussein has stockpiled the virus and may use it against the United States. The controversy involves the dangerous side effects this vaccine can bring, including in some cases death.
So, what happens if Washington does put a plan in motion? Our medical news correspondent Dr. Sanjay Gupta is standing by with us in New York. Joining me here Jeffrey Koplan of Emory University. And thanks for coming in and taking time to talk with us today about this. We were just chatting off camera, Sanjay, about the smallpox issue, and you've had quite a bit of experience with this.

JEFFREY KOPLAN, EMORY UNIVERSITY: I have.

HARRIS: Would you get the vaccine yourself?

KOPLAN: I don't feel I need it right now, based on what I do and what I know.

HARRIS: What's that mean?

KOPLAN: I'm working in a medical center, working with researchers, working with students, working with teachers. See patients occasionally. But I don't feel that the risk to me at the moment is particularly profound, and thus I don't need the vaccine. It's a good vaccine if there's a risk, but it's what is that risk.

HARRIS: Well, let's talk about that now. Sanjay, we've got quite a few e-mails. Let's toss the first one to you. We've got phone calls also coming in as well. The first e-mail we have here is from Jennifer Pace (ph) in Tallahassee, Florida. How long do small pox vaccines last?

SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Well, that's a good question. I saw that there were a lot of questions sort of along those lines. And the real answer, and unfortunately the real answer to a lot of these questions, is we're not exactly sure how long the small pox vaccine actually lasts.

There was a study recently done out of the University of North Carolina. Leon, you and I talked about this. Basically, what it showed that people who had been vaccinated before '72, who were 30 years or older, probably do have some protection, compared to people who have never been vaccinated. But whether it's enough protection, whether it's enough protection to actually protect you against the smallpox virus, if it existed today, that's hard to say. So we don't really know how long it lasts, although there may be a little more protection in those who have had the vaccine before.

HARRIS: OK. Let's go to the phones now. Cliff (ph) is on the line right now. Cliff (ph), are you there.

CALLER: Yes, I am.

HARRIS: Good morning. What's your question?

CALLER: Good morning. My question is that I was vaccinated twice in the past, once as a kid in grade school, and the other time, I believe, was when I shipped off to Vietnam. Both occasions, I had no complications. And if I took them now, at this time, would I be just as least unlikely to have complications this time around? And would I still be covered from the past vaccines?

HARRIS: That's a good question. Dr. Koplan, what do you think?

KOPLAN: There are a range of complications, and the people most susceptible to those complications are people who are getting the vaccine for the very first time, what are called primary vaccinations. A person who just called up has clearly had it a couple of times before, would be at lesser risk, but there are still some complications that anyone be would prey to, including what's called contact vaccination, where you rub the arm that's been vaccinated or somehow touch it, and then spread it somewhere else, either on yourself or on someone else.

HARRIS: Let's get back to the e-mails here. We have one from Nicole (ph) in New York. Either one of you can jump in on this one. What about the liability if someone dies?

GUPTA: I'm happy to take a stab at that. In fact, you know, I sort of made my way through some of the homeland security bill, Leon, that we've been hearing so much about. And in that homeland security bill are a few clauses about this very issue: The liability to the doctors, to the people who actually give the shots, the people who make the vaccine and to the federal government regarding the liability if someone is -- dies or is injured seriously by this vaccine.

In a nutshell, and Dr. Koplan can jump in as well, but doctors and the people who administer the shots seem to be pretty protected against lawsuits. They're indemnified is the word that they use, protected against lawsuits. The federal government is not. The vaccine makers do have partial protection, although they are contract employees of the federal government, so they're not necessarily fully protected as well. And Leon, I should point out, Dr. Koplan, who is probably one of only a handful of the doctors in the country who has actually treated anybody with small pox in this country may have some other comments about that as well.

KOPLAN: I think that Dr. Gupta has described the legal issues well. There is concern about those. But in my talk with many of our doctors at Emory's Health Science Center, the concern of all the doctors there is the welfare of the patient population and in the community at large. And in every major medical center today, there are very large numbers of people around who have poor immune systems, either because of a disease they have, like HIV or AIDS, or because they're being treated with chemotherapeutic agents that suppresses their immune system. These people are at tremendously greater risk from this virus circulating around. And one of the reasons there is reticence and reluctance on the part of a lot of our staff to have themselves vaccinated has nothing to do with themselves, their own health, or the legal issues. It involves the health of their patients.

HARRIS: That makes sense.

Let's go to the phones now, Judith (ph) is on the phone from Florida. Judith (ph), good morning.

CALLER: Good morning.

HARRIS: What's your question.

CALLER: I'm calling to ask about eczema. We understand you're not supposed to take the small pox vaccine if you have eczema. But I'm curious, if you have eczema in a very mild way, that is just periodic and it goes away, it has small patches, very little of it, and goes away with topic or cortisone treatment, if that should preclude you from getting the vaccine?

KOPLAN: Absolutely. Do not get the vaccine. And you stay away from people who have been vaccinated. The complications of what's called eczema vaccinatum, it's the spread of this virus across people who have eczema or atopic dermatitis, another term for that, is quite severe and it is not worth any risks to you to get this vaccine or to be near people who have had the vaccine.

HARRIS: Well, how do you handle that if you live with someone who's got eczema?

KOPLAN: Then you think twice before you get the vaccine. First of all, the vaccine is not being advocated for the population at large, so this is not a decision that people ought to be spending a lot of time about. If you're worried about vaccinations and you have children, you ought to make sure your children are vaccinated for things that there really are diseases around for, polio, DTP, measles, mumps, rubella, et cetera. If you're older, get the flu vaccine or get the pneumococcal vaccine. But don't spend all your time worrying about a vaccine for a disease that's been eradicated for 30 years.

HARRIS: Sanjay, one final comment on that?

GUPTA: You know, it's an interesting point. The eczema thing has been sort of very confusing as well. Just, I've been doing a little bit of research and reporting on this. Basically, eczema disrupts a lot of what are known as the mucosal surfaces in the body, as well as the skin. So if you've ever had eczema or if you have eczema now and then you get the small pox vaccine, you're at a little bit more risk of this vaccine actually further disrupting those areas. Just as Dr. Koplan said, this eczema vaccinatum, you've seen the pictures, Leon, they're pretty horrific, these ugly, disfiguring lesions and scars all over the body, even worse with people who have had eczema, a real problem in those patients, as Dr. Koplan said. There's about 28 to 30 million people out there who have either ever had eczema or have it now, that just should not get this vaccine.

HARRIS: I think the last time I saw shots of that stuff, it was like in a "National Geographic." That's really, really ugly stuff.

Dr. Sanjay Gupta in New York, we're going to move on, because we've got a lot of news to cram in this hour. We thank folks for calling in and then sending us all the e-mails. Don't worry, we're going to get to some more of this next week. We'll talk some more about it.

Dr. Jeffrey Koplan, not just of Emory University, I've also just been told, formerly of the CDC. Glad to have you in and appreciate your sharing the expertise with us this morning.

KOPLAN: Nice to be back here with you, thanks.

HARRIS: Thanks. We'll have to have you back. OK? Take care.

KOPLAN: Thank you.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com