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Smallpox Vaccinations Recommended for First Responders, Health Workers

The College of American Pathologists (CAP) is recommending a voluntary, pre-outbreak approach to smallpox vaccinations for "first responders" to a bioterrorism attack, including health care providers, certain laboratory workers, emergency room personnel, police, firefighters, medical examiners and others.

The CAP policy also recommends offering pre-outbreak vaccinations to the general public but only after the FDA licenses a smallpox vaccine.

"Physicians, laboratory workers, hospital employees and other emergency response personnel will be on the frontlines should a bioterrorist attack occur," said Jared N. Schwartz, MD, PhD, FCAP and chair of the CAP Committee on Emergency Preparedness. "It is in their best interest, and in the best interest of the public they serve, for these first responders to be protected through smallpox vaccination."

The CAP policy also states that the general public should be offered the option of smallpox vaccination, but only after they have been fully informed of the risks and benefits of inoculation and have signed an informed consent document.

The policy notes that widespread, pre-outbreak vaccinations should not occur in the general public until a sufficient stock of Vaccinia Immune Globulin (VIG), a blood product used to treat immuno-suppressed patients with vaccine associated infections, is developed.

"Without a stock of VIG, there is no compelling treatment option for those people with suppressed immune systems who develop vaccination associated infections related to this inoculation," said Schwartz. "That is why the college has recommended this phased approach, to maximize the protection of those most at risk from bioterrorist attack while minimizing any potential danger associated with this vaccine."

He added the pathologists are "hopeful that a new and safer vaccine will be available soon."

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