Get a Smallpox Shot? Even Doctors Divided

Dr. Charles Goodman is a pediatrician, one of the front-line health-care workers who will take care of children if they are exposed to a bioterrorism attack using the deadly smallpox virus.

But despite President Bush’s decision to step up efforts to vaccinate doctors and other health-care professionals against a smallpox outbreak, Goodman, who practices in the San Fernando Valley community of West Hills, says he will not take the vaccine -- nor will he give it to his own two children. Other doctors say the same thing. More than a third of 60 doctors surveyed at L.A. County’s Olive View-UCLA Medical Center, in Sylmar, said they either wouldn’t take it or were unsure.

“I would be afraid to take it,” said Goodman, who will counsel parents in his practice to study the side effects of the vaccine before requesting it for their children. “The side effects are serious, including death.”

Bush, citing a risk to public health from wholesale vaccination of Americans, stepped back Friday from earlier indications that he would make the vaccine available to all.

He said that medical professionals would be offered the vaccine on a voluntary basis and that the administration was recommending they take it. And Bush ordered that military personnel and government employees in “high-risk parts of the world” be immunized. He said the government had stockpiled enough of the vaccine to immunize all Americans, should it become necessary.

But the decision to take the vaccine or provide it to one’s children is a difficult one. Most people know little about this relatively primitive vaccine, which does not contain live smallpox but does contain a live virus called vaccinia. It can have severe side effects for children, people with depressed immune systems or anyone who has ever had eczema or other skin conditions. It is not recommended for anyone who is pregnant or nursing.

Throughout the nation, parents, doctors and others wrestle with a decision that at best is based on a combination of fear and faith -- fear that a smallpox attack is imminent and faith that the vaccine will be safe.

“I’m terrified,” said Linda Sides, 29, who was shopping with her husband and two children in the St. Louis suburb of Town and Country. “I think about it every day. I have nightmares. I would do it to protect my beloved children, and myself.”

Sides said she would give her children the vaccine if she knew that it did not contain a mercury preservative, which some parents fear causes neurological damage. But her husband, Tony, hesitated to go even that far.

“I think it’s just talk,” he said of the smallpox threat.

Working the late-lunch crowd at a Miami cafe, Silvia Stanechuk said she would feel more secure if her 10-month-old son were vaccinated.

“I don’t know if it would be good or not for my baby, but it would make me feel more at peace,” the 23-year-old said.

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More Data Wanted

In Los Angeles, elementary schoolteacher Elliott Cruzata said too little is certain about the vaccinations to allow him to decide.

“There’s got to be more research,” he said. “They’ve got to give us more information before we can make our decision.”

Natalie Siman, 45, co-owner of a clothing boutique in downtown Ventura, credited politics more than health concerns with her decision not to vaccinate herself or her three children. “I don’t want to give [the Bush administration] the satisfaction of putting everyone into this terrorist panic,” she said.

But Carolyn Seiler, a mother of two from Huntington Beach, said she is “petrified” of a smallpox attack and figures there must be something to the threat if the administration is recommending vaccinations for soldiers and doctors.

“I think the president knows something about a smallpox threat to be thinking about taking these steps,” said Seiler, 44.

It is the recommendation of the federal Centers for Disease Control and Prevention that persuades Dr. Pejman Salimpour, a pediatrician practicing on L.A.’s Westside and Sherman Oaks, he will take the vaccination.

“Since we will be the first line of defense against [an outbreak], we can’t afford to be ill,” Salimpour said.

Dr. Larry Gardner, a Las Vegas surgeon, agreed and downplayed the vaccine’s side effects, saying they were more likely to affect people already weak or sick.

“If you’re perfectly healthy, the risk is significantly less,” Gardner said. “I absolutely would be vaccinated.”

Like large health-care agencies throughout the country, the Los Angeles County health department has developed plans to vaccinate 100 volunteers at each of its 83 hospitals. Those emergency room doctors and nurses, along with other medical specialists, laboratory workers and support staff members, could then begin administering vaccinations around the clock, should a case of smallpox be detected.

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Front-Line Uncertainty

But even here, where doctors and nurses know they would be on the front lines of an attack, health-care workers are torn about whether to be vaccinated. The union that represents nurses and other hourly workers opposes the plan, which union representatives say would not protect health-care workers from potential side effects.

Annelle Grajeda, executive director of Local 660 of the Service Employees International Union, criticized the Bush administration Friday, saying it had granted the company that makes the vaccine immunity from lawsuits if people develop side effects, while encouraging workers to take the vaccine. The legal immunity was part of Homeland Security legislation passed by Congress and signed by the president.

Catherine Lefkowitz, a nurse at the county Women’s and Children’s Hospital, said the vaccine places people at “unnecessary risk.”

“Health-care workers do not want to lose income or their jobs if they can’t work as a result of the vaccine,” Lefkowitz said.

Dr. Steven Murphy, a third-year family practice resident at Harbor-UCLA Medical Center, said the county should provide screenings to ensure that people receiving the vaccine aren’t at greater risk for complications.

Doctors and administrators were divided at private hospitals as well.

Dr. Robert Rigg, medical director of West Oaks Urgent Care in Canoga Park, said he would not require his staff to be vaccinated because the risks are too great.

But Dr. Brian Johnston, who runs the emergency room at White Memorial Medical Center, said he would be vaccinated, despite the risk of side effects.

“I would rather be a little sick than a little dead,” he said.

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Times staff writers Jenifer Ragland, Tom Gorman, Stephanie Simon, David Reyes, Jane E. Allen, Charles Ornstein, Stephanie Stassel and Anna M. Virtue contributed to this report.