Screening may find some servicemembers ineligible for smallpox shots
Stars and Stripes January 15, 2003
HEIDELBERG, Germany — Army medical officials estimate three out of every 10 soldiers will fail to pass stringent medical screening rules for the newly revived smallpox inoculation program.
But soldiers shouldn’t think that just because they can’t get the shots that they’ll be staying home.
“It does not mean they will not deploy,” cautioned Lt. Col. (Dr.) Loren Erikson, the Army’s chief of preventative medicine in Europe. “If you are deferred from the vaccination, you are still going to go downrange.”
The Army is beginning vaccinations against the deadly disease for all troops now deploying to the Middle East and Central Asia because of fears Saddam Hussein or Osama bin Laden could unleash smallpox as a biological weapon.
But because of the possibility of severe — and even deadly — side effects, Army medical officials are implementing a thorough screening process that will defer smallpox vaccinations for about 30 percent of the force.
Among the exemptions:
Certain types of skin conditions such as eczema or very severe acne;Lowered immunity because of, for example, HIV or chemotherapy; orPregnancy.If a soldier’s spouse, or other immediate household members, has any of the above conditions, that would trigger deferment as well.
“As we start this program we want to be very careful and very deliberate,” Erikson said. “Even if there is a very small risk, then we want to make the right decision.”
Those who don’t get the shots, however, shouldn’t worry about being left out in the cold should there be a smallpox attack.
“If there is an attack, a credible exposure of the smallpox virus, then everyone will be vaccinated,” Erikson said. “Within the first four days of an exposure, you can still get the vaccination which will either prevent the disease or at least make it much less severe.”
Those who have already been vaccinated — either as children or when they first came into the military — shouldn’t think they won’t have to get the shots again. In fact, they get more shots.
For those who have never had the vaccine, the inoculation involves three shots. Otherwise, it’s 15 needle pokes.
“The issue for someone who has been previously vaccinated is that they may have some residual immunity and so we need to make sure the virus is correctly introduced to ensure full protection,” Erikson said.
Smallpox was virtually eradicated by the early 1970s through an aggressive worldwide vaccination program. The military stopped inoculating most recruits by 1990.
One of the reasons it stopped was that the smallpox vaccine is known to have harsh side effects in certain cases. Unlike most inoculations these days, the smallpox vaccine uses a live virus that leaves a nasty pus-filled blister and a permanent scar.
That much is guaranteed, if the vaccination is working correctly. Flu-like symptoms are also common, including fevers, body ache and general fatigue for about two weeks after the shots.
The lymph nodes in the armpit of the vaccinated arm or in the neck may become large and painful for a week or so after the vaccination as well, say officials.
But all that is a lot better than getting the disease itself, which slowly kills 30 percent of those who contract it as the body is covered with lesions and burns with fever.
“Even among those who survive, 70 percent will experience severe scaring and/or blindness,” said Erikson.