By LISA BAUM
DC 37 Safety Unit

Vaccinations have become a commonplace part of modern medical care. However, as President Bush prepares the country for a war against Iraq, he has pushed through a controversial program to fight a war right here at home — the war against bioterrorism.

And the variola virus that causes the dreaded smallpox disease has been declared Public Enemy #1. Smallpox is one of the oldest diseases known to humankind. It has caused approximately 500 million deaths — more than any other infectious disease.

Safety Spotlight

Smallpox was one of the most devastating infectious diseases in world history, until a vaccine was developed more than 200 years ago. But the smallpox vaccine uses the live form of a weaker virus, which can cause severe side effects.

Milder reactions can include soreness at the vaccination site (arm) and armpit glands, low fever and mild flu-like symptoms. One out of three people who get the shot may feel bad enough to miss work or school or have trouble sleeping.

Out of every 1 million people vaccinated for the first time, about 15 may face life-threatening complications, and one or two may even die.

Do not get vaccine IF:
The U.S. Centers for Disease Control recommends that people with the following conditions (or who live with people with the following conditions) not volunteer for the smallpox vaccine:

Eczema or atopic dermatitis (even if the condition is not currently active).
Active skin conditions such as burns, chickenpox, shingles, impetigo, herpes, severe acne or psoriasis.
A weakened immune system (this can be due to chemotherapy, organ transplant, HIV/AIDS infection, medications to treat autoimmune disorders).
Pregnancy or plans to become pregnant within one month.
Diabetes.

In addition, individuals should not get the smallpox vaccine if they:

Are allergic to the vaccine or any of its ingredients.
Are less than 18 years of age.
Have a moderate or severe short-term illness.
Are currently breastfeeding.
Have a child under one in their household.
Use steroid eyedrops

There is a great deal of disagreement about how real the current smallpox threat is. However, the Bush administration is committed to vaccinate approximately 500,000 public health and emergency room workers over the next few months.

The plan’s “second wave” would cover emergency responders, including ambulance crews, police and firefighters. A “third wave” would involve the public.

The dilemma with this vaccination “war” is that the cure may cause more injuries (and even deaths) than the threat of smallpox. Because the vaccine uses the live vaccinia virus, there can be serious side effects (see Spotlight).

Many unions, including AFSCME, have urged city, state and federal officials to implement protections for workers before going ahead with the vaccinations. Missing from the Bush plan are:

paid time off if a worker becomes ill from the vaccine.
the right to Workers’ Compensation for smallpox response team “volunteers.”
a requirement to use available safer needles.
safeguards to prevent employers from coercing employees to get the vaccine or punishing workers who decide not to volunteer for the smallpox vaccine.

Volunteering for the smallpox response program is an individual decision. District Council 37 members have often been on the frontlines during major emergencies and healthcare crises. However, members deserve all the protection possible so that they can perform their duties to the best of their abilities.

At meetings with the Health Dept. and the Health and Hospitals Corp., DC 37 has pushed for screening out those at risk (see “Spotlight”) and implementing protections for members who get the shots. No agreements were reached, but as PEP went to press a session was being scheduled with the city Office of Labor Relations, said DC 37 Research and Negotiations Director Dennis Sullivan.

Union nurses know the hazards

By ALFREDO ALVARADO

President Bush has had difficulty convincing both the international community and Americans at home of the need to launch a military attack against Iraq. His ambitious plan to inoculate 500,000 health care workers with the smallpox vaccine has also met with widespread skepticism.

"We have serious concerns about this plan,” said Gloria E. Acevedo, president of the United Federation of Nurses and Epidemiologists Local 436. “We were told that our members would be considered first in this program, not contract nurses, but the city has been training outsiders along with our members,” she said.

Ms. Acevedo is also concerned about liability, compensation and safety issues. “The needles that they are using are unsafe. And what happens if one of these contract nurses gets sick?”

Bush’s Homeland Security Act provides liability protection for vaccine manufacturers, but not for workers who get the shot. There is no provision for treating or paying individuals who suffer severe reactions from what is often described as the most dangerous inoculation available today.

Vaccine doses are delivered by 12 to 15 jabs in the upper arm with a fork-like instrument. Needle sticks are a major source of infection for nurses. “Safety-designed needles are available, but the program does not require them,” said Ms. Acevedo.

Unions representing health care workers in California, Connecticut, New Jersey, Wisconsin and Pennsylvania have urged members not to volunteer, citing the lack of compensation for anyone who becomes sick from the side effects. More than 80 hospitals across the country have refused to let employees participate.

“We don’t want to end the vaccination program,” said Barbara Coufal, a lobbyist for DC 37’s parent union, the American Federation of State, County and Municipal Employees. “We just want it to be delayed until we get all the problems worked out.”