January 16, 2003 -- Colorado hospital chain not participating in smallpox vaccination


Denver Post, Friday, January 10, 2003

Centura rules out staff smallpox shots

By Karen Auge Denver Post Medical Writer

Friday, January 10, 2003 - Colorado's largest hospital system has
joined a handful of others nationwide and decided its employees will
not be vaccinated against smallpox.

Centura Health, which operates 10 hospitals in Colorado - including
St. Anthony Central, the state's largest trauma center, and St.
Mary-Corwin, one of southern Colorado's largest hospitals - told state
officials Thursday it won't participate in the government vaccination
program set to begin at the end of this month.

Joseph Swedish, Centura Health's president and chief executive, said
the company needs more answers about the vaccine and its risks "before
we ask our associates to put themselves and others at risk for
possible harmful reactions to the vaccine."

Centura is the first in Colorado to say it won't offer vaccines to
employees; across the state many hospitals are still debating the
issue.

Nationwide about three or four hospitals have declined to participate
in the vaccination program, according to the American Hospital
Association.

Centura's decision won't hamper the state's smallpox preparedness
plan, said Dr. Ned Calonge, Colorado's acting chief medical officer.

Nevertheless, he said, "we're hoping this isn't Centura's final
decision."

Colorado has told the federal government, in a plan submitted last
month, that about 1,400 doctors, nurses, paramedics and other
so-called "first-responders" to emergencies would be part of a first
wave of volunteers to be vaccinated against smallpox. That number was
based on estimates provided by the state's hospitals.

Laura Wegscheid, a Centura spokesperson, said she didn't know how many
of that estimated 1,400 would have been Centura employees.

Calonge said he doesn't know what the final number of participants
will be, and for now, neither do hospitals.

"We're still working with the original number," Calonge said. "We
won't have the actual number (of vaccine doses) that we will request
until just prior to when they will be shipped."

Calonge said that if there is a smallpox outbreak, hospitals,
including Centura's, would use standard procedures to protect against
the spread of contagious diseases. A person exposed to smallpox can be
vaccinated up to five days later and still be protected.

The Bush administration has asked states to vaccinate health and
emergency workers as part of a plan to prepare the nation in case of a
bioterror attack. Last month, the president said the vaccine would
eventually be available to anyone who wanted it.

Smallpox was declared wiped out in 1984, and there has not been a case
of the deadly disease anywhere in the world since.

However, there are widespread fears that terrorists or rogue
countries, such as Iraq or North Korea, may have gotten hold of the
virus.

Smallpox vaccinations haven't been routinely given in the United
States since 1972. At that time, the disease was long gone from this
country, and the risks posed by the vaccine prompted a campaign - led
largely by the late Dr. Henry Kempe, a Denver pediatrician - to stop
using it.

"We were killing more people than we were saving," said Dr. Ted
Eickhoff, director of infection control at the University of Colorado
Hospital, who worked with Kempe at CU.

It is that possibility of severe, even fatal, reaction to the vaccine
that has caused hospitals to question whether they should participate
in the government program.

"We're concerned about side effects if a person is vaccinated and the
potential for transmitting it to others," said Dr. Norman Fujita, an
infectious disease specialist at St. Anthony Central.

Hospitals are also concerned about who would bear the cost of treating
a health worker or patient who gets sick as a result of the
vaccination.

"There are liability issues, compensation issues, risks to staff,
risks to patients" to be considered, said Eickhoff.

Officials at the Centers for Disease Control and Prevention say they
are working to resolve those questions, which were not addressed in
the homeland security legislation that launched the vaccination
program.

Eickhoff said infectious disease staff at the University of Colorado
Hospital hashed out vaccination pros and cons at a meeting Thursday,
but a final decision on what the hospital will do is likely at least a
week away.

At Presbyterian/St. Luke's, the state's largest hospital, a task force
on the subject held its first meeting Thursday, said hospital
spokeswoman Stephanie Lewis.

At Swedish Medical Center, which is participating in the program,
employees have received information packets on the vaccine, and they
are asking questions, said Sue Mazula, the hospital's manager of
infection control.

Mazula said Swedish initially told the state that it might have up to
100 staff members who would be vaccinated.

But she said she has no idea how many will actually volunteer.