Time to vaccinate everyone under 30 against smallpox?

BALTIMORE -- Immunizing young Americans against smallpox before a bioterrorist attack might save many more lives than a strategy focused exclusively on isolating and vaccinating those at risk after an attack. But a mass-vaccination approach would cost more up front and would have to be done cautiously because of illnesses and deaths the vaccine itself could cause.

Those conclusions, from an analysis performed by researchers at the University of Michigan Health System, were presented May 7 at the meeting of the Pediatric Academic Societies.

The federal government currently prefers a post-attack strategy called ring vaccination," in which individuals identified with smallpox would be quarantined and their close contacts would receive smallpox vaccine after exposure to reduce the spread of illness.

The study examined the cost-effectiveness of different pre-attack vaccination strategies in conjunction with ring vaccination, compared to ring vaccination alone. It found that campaigns to immunize 50 percent to 75 percent of Americans aged 1 to 30 years, if completed before a smallpox terrorist attack, could save hundreds of lives compared to the potential deaths from an attack managed with only with ring vaccination.

The researchers, led by U-M pediatrician and internist Matthew Davis, M.D., M.A.P.P., hope their results may help guide public officials at a time when terrorist attacks and anthrax cases have renewed fears of a smallpox attack and led the U.S. government to increase its stockpile of smallpox vaccine.

Routine inoculation of US children was stopped in 1972 when the risk of vaccine side effects was judged to outweigh the benefit. National infectious disease experts assume that individuals immunized prior to 1972 have no remaining immunity against smallpox. This is a major concern, because smallpox is lethal in about 30 percent of those it infects.

However, the smallpox vaccine composed of live vaccinia (cowpo

Contact: Kara Gavin
University of Michigan Health System

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