County Reduces Vaccine Request

Los Angeles County health officials have pared their request to the federal government for smallpox vaccine after refining their preparations for possible bioterrorism.

The county Department of Health Services this week asked for 9,190 doses of the vaccine, primarily for hospital emergency room workers. Just one week ago, county health officials had said they would seek up to 20,000 doses from the U.S. Centers for Disease Control and Prevention.

Dr. Laurene Mascola, chief of the county’s acute communicable disease control unit, said officials reduced their request after talking with health officers from other states about their plans.

Oregon and Georgia, for instance, are each asking for fewer than 1,000 doses. Michigan is seeking 5,000 to 7,000. California health officials have requested 40,000 doses for areas outside Los Angeles County.

County health officials decided to expose as few people as possible to the risks associated with the vaccine, including death, Mascola said. In addition, vaccinating 20,000 people in the county would have diverted limited public health resources from other pressing activities.

“Let’s just vaccinate the minimal number of individuals to get the job done,” Mascola said. “The more people you vaccinate, the greater the risk of adverse reactions.”

The smallpox virus, which is highly contagious, was eradicated worldwide in the 1970s, but officials fear that vials of the virus kept in storage in the former Soviet Union may have fallen into the hands of Iraq or North Korea. The concern took on new urgency after the terrorist attacks and anthrax scares last year.

Those cut from the county’s plan include 5,000 paramedics and firefighters who respond to 911 calls. The county has said it will request vaccine for them later. The health department also reduced its suggested allocation of vaccine for hospitals.

Previously, the county had planned to give doses to hospitals based on size, with the largest receiving 300. Now, all hospitals will be offered 100 doses, consistent with CDC recommendations.

Before vaccinations begin, President Bush must give his approval. The vaccinations would be voluntary.

Some health groups said they are nervous that officials have not done enough to protect the public from the risks of the vaccine. Those most at risk for complications include people with HIV, pregnant women and patients with eczema.

“We’re encouraging people not to volunteer unless better safeguards are in place,” said Christy Hawkins, a spokeswoman for the Service Employees International Union, which includes health-care workers among its members.