U.S. Soldier Dies Several Days After Smallpox Shot
Woman Vaccinated Against Smallpox Dies
Second worker dies of heart attack after smallpox vaccination

U.S. Soldier Dies Several Days After Smallpox Shot
By Paul Simao
http://story.news.yahoo.com/news?tmpl=story2&cid=564&ncid=564&e=1&u=/nm/20030328/ts_nm/health_smallpox_dc_13

ATLANTA (Reuters) - A U.S. soldier who was recently vaccinated
against smallpox has died from a heart attack, the third death among
those participating in the federal campaign to inoculate hundreds of
thousands of military personnel and health care workers.

A Department of Defense (news - web sites) official said on Friday
that the 55-year-old National Guardsman had died in an unidentified
U.S. military hospital on March 26, six days after receiving his
smallpox vaccination.

Two female health care workers who were recently vaccinated against
smallpox have died in the past week of heart attacks.

Col. John Grabenstein, scientific director for the Pentagon (news -
web sites)'s smallpox vaccination program, said the deceased soldier
was being treated for high cholesterol and was a smoker at the time
he received his smallpox jab.

"We are categorizing this event at the moment as unlikely to be due
to smallpox vaccination," Grabenstein said during a conference call
with other smallpox vaccination experts and government immunization
experts.

"We are not finished with our evaluation," said Grabenstein, who
noted that more than 350,000 soldiers had received smallpox shots
since late last year when President Bush (news - web sites)
authorized the vaccination program.

The soldier's death, however, occurred amid growing scrutiny of the
campaign. There have been more than a dozen other cases of heart-
related complications in U.S. soldiers and health care workers who
received the vaccine.

The possibility of a link between the deaths and the vaccine prompted
the U.S. Centers for Disease Control and Prevention (news - web
sites) to recommend this week that people with heart disease not be
vaccinated until further notice.

Earlier this month, top U.S. health officials had said that reports
of side-effects linked to the current smallpox program were
overblown. Smallpox kills about 30 percent of its victims and scars
the remainder for life. It was eradicated in 1979.

The United States stopped routine smallpox vaccinations in 1972, but
decided to resume them for select groups last year as fears grew that
the virus could be used as a weapon by radical groups or countries
like Iraq (news - web sites).

When administered in the past the vaccine killed between one to two
out of every million people inoculated and caused others to suffer
brain damage. But it has never before been linked to heart problems.

Second worker dies of heart attack after smallpox vaccination

LAURA MECKLER, Associated Press writer   Thursday, March 27, 2003  
(03-27) 15:11 PST WASHINGTON (AP) --

A second health care worker has died of a heart attack after receiving the
smallpox vaccine, and officials are investigating whether vaccinations are
to blame for cardiac problems seen in 17 people who have been inoculated.

The vaccine has never been associated with heart trouble, but as a
precaution, the Centers for Disease Control and Prevention is advising
people with a history of heart disease not to be vaccinated until further
investigation is complete.

CDC officials said Thursday there was some evidence the smallpox vaccine
has played a role in heart inflammation. They were less certain whether
three recent heart attacks were related to the vaccine.

In New York state, officials halted smallpox vaccinations altogether while
the heart disease issue is sorted out.

Also Thursday, an expert panel advising CDC raised questions about the
government's vaccination program.

The Institute of Medicine suggested the CDC was moving too quickly beyond
its first stage of vaccinations, which include public health and hospital
workers, into a second stage, which includes a large group of emergency
responders. The report, released Thursday, also called on the federal
government to compensate people injured by the vaccine.

On Capitol Hill, lawmakers struggled to do just that, but a House vote
scheduled for Thursday was abruptly canceled amid questions about whether
Republicans had enough votes to beat back a somewhat larger Democratic
compensation plan.

The issue of smallpox vaccine safety gained new urgency this week after a
Maryland nurse died Sunday of a heart attack, and the CDC launched an
inquiry on a possible connection between heart disease and the vaccine.

The second death came Wednesday to Virginia Jorgensen, 57, of St.
Petersburg, Fla., who was a nurse's aide at a local hospital. She suffered
a heart attack about two weeks after being vaccinated against smallpox.

Like the other vaccine recipients with heart troubles, Jorgensen had a
history of high blood pressure and other factors that put her at risk for
heart attack.

"She's been having heart problems for almost a year," her husband, Robert
Jorgensen, said in an interview Thursday. After the vaccination, he said,
"within a few days she was feeling like she had a cold coming on and then
it got bad."

The recent deaths "display a sense of urgency" and make it plain
legislation is needed, said Rep. Richard Burr, R-N.C., the chief sponsor of
the Republican legislative package.

The latest GOP version would pay about $262,000 if a person dies or is
permanently and totally disabled by the vaccine. Those less severely
injured could receive up to $50,000 per year in lost wages, up to $262,000.
They could also get unpaid medical expenses.

Democrats want more for lost wages and want funding for the program
guaranteed.

On the question of heart problems, CDC officials are investigating 17
cases, including seven civilians and 10 people vaccinated in the military
program. The civilian cases include three women who had heart attacks --
two of whom died -- and two with angina, or chest pain. The last two
suffered heart inflammation, and all 10 military vaccinees suffered heart
inflammation.

Federal officials see some evidence that the vaccine is playing a role in
these inflammation cases, said Walter Orenstein, director of the CDC's
National Immunization Program. He said there were reports from decades ago
in Europe of similar problems with another strain of smallpox vaccine. They
are less convinced that the heart attacks and angina cases are related, he
said.

"This very well could be coincidental," Orenstein said.

The vaccine carries well-documented side effects, but they have never
included heart problems. Still, the data were gathered years ago during a
time when most people being vaccinated were young children not likely to
have heart trouble.

The CDC was consulting with cardiac experts on to consider whether
something in the vaccine might be triggering heart problems in people who
already have risk factors.

Existing guidelines already screen out people with conditions that are
known to increase the chances of side effects, including people with HIV,
pregnant women, organ transplant recipients and people with a history of
skin disorders.

The smallpox vaccination program has gotten off to a slow start. As of
March 21, states had vaccinated just over 25,000 civilians, mostly in
public health departments and hospitals. Concerns about the vaccine's risk
have helped keep the numbers well below the 450,000 initially expected.

Several hundred thousand military personnel have been vaccinated.

Based on studies in the late 1960s, experts estimate that one or two people
out of every million being vaccinated for the first time will die. The
death rate for those being revaccinated was lower: Two people died out of
8.5 million who were revaccinated in a 1968 study.

Additionally, 14 to 52 people out of every million being vaccinated for the
first time are expected to suffer life-threatening side effects.

That's because the smallpox vaccine is made with a live virus called
vaccinia, a cousin to smallpox which can cause illness if it escapes the
inoculation site and infects another part of the body. Vaccinia can also
infect those who touch someone else's vaccination site.

------------------------------------------------------------------------
Associated Press writer Rachel La Corte in Tampa, Fla., contributed to this
report. 

http://www.sfgate.com/cgi-bin/article.cgi?file=/news/archive/2003/03/27/nati
onal1634EST0738.DTL
 

  Woman Vaccinated Against Smallpox Dies
      Md. Nurse Vaccinated Against Smallpox Dies After Heart Attack; Health
Officials Investigate
      http://abcnews.go.com/wire/Living/ap20030325_2109.html
      The Associated Press





      WASHINGTON March 25 -

      A Maryland nurse recently vaccinated against smallpox died over the
weekend of a heart attack, and health officials are trying to determine
whether the inoculation contributed to her death, an official familiar with
the case said Tuesday.

      Based on historic data, a small number of people who receive smallpox
vaccinations will die, but the vaccination has never been associated with
heart problems before.

      The official, who spoke on condition of anonymity, said the woman may
have had a history of heart disease before receiving the vaccination.

      It's the first death associated with either the civilian vaccination
program that began two months ago or the military program launched in
December.

      As of March 14, states had vaccinated 21,698 civilians, mostly in
public health departments and hospitals. Concerns about the vaccine's risk
have helped keep the numbers well below the 450,000 initially expected.

      The military program, where vaccinations are mandatory, has vaccinated
"well over" 100,000 soldiers, the Pentagon said.

      Based on studies in the late 1960s, experts estimate that one or two
people out of every million being vaccinated for the first time will die.
The death rate for those being revaccinated was lower: Two people died out
of 8.5 million who were revaccinated in a 1968 study.

      Additionally, 14 to 52 people are expected to suffer life-threatening
side effects.

      That's because the smallpox vaccine is made with a live virus called
vaccinia, a cousin to smallpox which can cause illness if it escapes the
inoculation site and infects another part of the body. Vaccinia can also
infect those who touch someone else's vaccination site.

      Besides the Maryland case, two other cases of heart trouble among
people vaccinated have been reported, one by the Centers for Disease Control
and Prevention and one by the Pentagon.

      The civilian case involved a 60-year-old man who already had symptoms
of heart disease before being inoculated. He had chest pains while playing
tennis four days after getting the vaccine, was diagnosed with a blocked
coronary artery and had an angioplasty.

      Additionally, the Pentagon reported that one person had a heart
infection.

      The last U.S. case of smallpox was in 1949, and routine vaccinations
against the disease ended here in 1972, as the disease was on the wane
globally.

      In December, President Bush ordered that vaccinations resume for
health workers, emergency responders and the military amid fears that
smallpox could be used as a bioterror weapon.

      BC-Smallpox Vaccinations, 1st Ld-Writethru,470

      Woman vaccinated against smallpox dies after heart attack

      Eds: INSERTS new graf 4, The woman, to UPDATE with dates

      By LAURA MECKLER

      Associated Press writer

      WASHINGTON (AP) A Maryland nurse recently vaccinated against smallpox
died over the weekend of a heart attack, and health officials are trying to
determine whether the inoculation contributed to her death, an official
familiar with the case said Tuesday.

      Based on historic data, a small number of people who receive smallpox
vaccinations will die, but the vaccination has never been associated with
heart problems before.

      The official, who spoke on condition of anonymity, said the woman may
have had a history of heart disease before receiving the vaccination.

      The woman, a health care worker, was vaccinated March 18 and died five
days later, on March 23, according to Karen Black of the Maryland Department
of Health and Mental Hygiene.

      It's the first death associated with either the civilian vaccination
program that began two months ago or the military program launched in
December.

      As of March 14, states had vaccinated 21,698 civilians, mostly in
public health departments and hospitals. Concerns about the vaccine's risk
have helped keep the numbers well below the 450,000 initially expected.

      The military program, where vaccinations are mandatory, has vaccinated
"well over" 100,000 soldiers, the Pentagon said.

      Based on studies in the late 1960s, experts estimate that one or two
people out of every million being vaccinated for the first time will die.
The death rate for those being revaccinated was lower: Two people died out
of 8.5 million who were revaccinated in a 1968 study.

      Additionally, 14 to 52 people are expected to suffer life-threatening
side effects.

      That's because the smallpox vaccine is made with a live virus called
vaccinia, a cousin to smallpox which can cause illness if it escapes the
inoculation site and infects another part of the body. Vaccinia can also
infect those who touch someone else's vaccination site.

      Besides the Maryland case, two other cases of heart trouble among
people vaccinated have been reported, one by the Centers for Disease Control
and Prevention and one by the Pentagon.

      The civilian case involved a 60-year-old man who already had symptoms
of heart disease before being inoculated. He had chest pains while playing
tennis four days after getting the vaccine, was diagnosed with a blocked
coronary artery and had an angioplasty.

      Additionally, the Pentagon reported that one person had a heart
infection.

      The last U.S. case of smallpox was in 1949, and routine vaccinations
against the disease ended here in 1972, as the disease was on the wane
globally.

      In December, President Bush ordered that vaccinations resume for
health workers, emergency responders and the military amid fears that
smallpox could be used as a bioterror weapon.



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