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Who Should and Shouldn't Get Smallpox Vaccines

Aired May 21, 2003 - 19:35   ET


DARYN KAGAN, CNN ANCHOR: Let's turn to some health news now. And the threat of terrorist attacks led to renewed attention to biological warfare and the effort to begin giving people in the U.S. vaccines against smallpox. Well it turns out that millions who received vaccinations before they were phased out in the '70s might still be protected. There's new research showing that people who received the smallpox vaccination as long ago as 75 years ago might still have some immunity.
Our own Dr. Sanjay Gupta is here to put that in perspective. Seventy-five years ago and it still might work.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: I tell you, you know. And that was one of the biggest question I got during all the bioterrorism scares. The people would came up to me and literally showed me their little scar from the smallpox inoculation, said am I still protected? And the answer as you said, Daryn, probably. Maybe not fully and that's really the next step.

But the researchers now at Oregon Health Science University have actually studied people, mainly people over about 60 years ago, but up to 75 years ago and found there is a certain degree of immunity still, immunity against the smallpox virus in those people who were inoculated back then.

Remember now back in '72 when smallpox vaccinations actually stopped, people -- children age one to two were getting the shots and folks were some reason coming contact with the smallpox virus because they were doing research or something like that are still getting booster shots every five years. But the actual production of the vaccine stopped in 1983.

So they've haven't been making this in 20 years. They recently started again because of the bioterrorism scares. And about 36,000 health care workers have vaccinated. The plan is try and vaccinate 500,000 military. The president got inoculated, as you know. And then health care workers as well.

But it is interesting. The real question I think for everybody, myself, you as well is is it enough protection? And that's the answer we don't know yet.

KAGAN: Well and some people -- you know you have the mark on your arm or on your hip. And you wonder how much immunity do you have left? Is the a test to find out how well your vaccine is working? GUPTA: Yes, that's a good question. In fact, a few months ago when this was really a hot issue and they were deciding if they were going to inoculate and all that sort of thing, researchers down in North Carolina tested this.

They actually figured out how much of an antibody response, and the name basically means that how cells, how much of the fighter cells your body produces in response to the smallpox virus. And they can measure that. And they can measure that someone who got the shot a year ago has a much more profound response, a much more production of the fighter cells versus someone who got the shot 75 years ago.

But the interesting thing, even back then, back when inoculations were still routinely given, we didn't know. They didn't know how much they needed to give. How much immunity they needed to build up. The only way to really test that is to actually knowingly expose people to smallpox virus. and say, oh, that was enough...

KAGAN: Well it's kind of a high risk way to do it.

GUPTA: Can't do it. Right.

KAGAN: Well speaking of risks, there's people out there who are wondering do I need one? Should I get one? And there is some risk or a significant amount of risk in getting the vaccine.

GUPTA: Yes, there is. And to answer your first question, I think that it's been pretty clear. I think unless you have some specific reason that you might come in contact with someone with smallpox, there's probably no reason for you to get the smallpox vaccine.

Now if you have the conditions listed on the screen here, there's probably even a better reason for you not to get the vaccine because it could be very dangerous. Eczema, which is a very common skin condition. Immune deficiency disorders, pregnant women, people living with babies under one. Now right away this list excludes up to 50 million people who should probably never get this vaccine.

And there are risks, Daryn, there are very significant risks to this vaccine which is why people have been so cautious about it. One to two people out of a million will die, 15 of a million will have significant, life-threatening illnesses, and most of the people will have more sort of just annoying symptoms, such as fever, swollen lymph nodes, things like that.

KAGAN: I think one that caught my attention, people with living with babes under one? Why is that?

GUPTA: Well because they are particularly more vulnerable.

KAGAN: The kids?

GUPTA: The kids are more vulnerable if you pass it on. Pregnant women for the same reason you can pass on to the fetus. So it excludes a lot of people. But you know it's not out there right now. It's all sort of a prophylactic measure. Back in the '70s when they did this, smallpox existed. Today it doesn't. I wouldn't recommend getting the vaccine unless there was a real reason to.

KAGAN: But for now keep calm.

GUPTA: That's right. Keep calm.

KAGAN: Dr. Sanjay Gupta, thank you so much.


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