1. Smallpox Vaccination for Response Teams The Decision is Yours! of and

2. US Government Backs Vaccination After the events of September and October, 2001, the US government took steps to improve the countrys preparedness against terrorism, including bioterrorism. After the events of September and October, 2001, the US government took steps to improve the countrys preparedness against terrorism, including bioterrorism. On Friday, December 13, 2002, President Bush announced plans to provide specific groups of people with smallpox vaccinations. On Friday, December 13, 2002, President Bush announced plans to provide specific groups of people with smallpox vaccinations. Vaccination is voluntary Vaccination is voluntary

3. Smallpox Response Teams Public Health Response Teams (5 regional teams) Public Health Response Teams (5 regional teams) Physician team leader Physician team leader Epidemiologist Epidemiologist Public health nurse/vaccinator Public health nurse/vaccinator Lab worker Lab worker Law enforcement agent Law enforcement agent State regional planner State regional planner LINCS regional planner LINCS regional planner Industrial hygienist Industrial hygienist

4. Smallpox Response Teams Hospital Health Care Response Teams (1 per hospital) Hospital Health Care Response Teams (1 per hospital) ED and ICU nurses, physicians, technicians ED and ICU nurses, physicians, technicians Housekeeping/laundry Housekeeping/laundry Security Security Respiratory therapy Respiratory therapy Infection control Infection control Lab Lab Sub-specialists: Pulmonary, Dermatology, ID, Peds, etc Sub-specialists: Pulmonary, Dermatology, ID, Peds, etc Engineering/HVAC Engineering/HVAC Occupational health/vaccinators Occupational health/vaccinators

5. What you need to know… Smallpox Disease Smallpox Disease Smallpox Vaccine Smallpox Vaccine Normal and abnormal vaccine reactions Normal and abnormal vaccine reactions Caring for the vaccination site Caring for the vaccination site Who should not get the vaccine Who should not get the vaccine Risks vs benefits Risks vs benefits

6. What you need to know… Smallpox – The risks Smallpox – The risks Smallpox has been eradicated worldwide Smallpox has been eradicated worldwide There has not been a case of smallpox since 1977 There has not been a case of smallpox since 1977 Historically, 30% of smallpox patients died Historically, 30% of smallpox patients died Smallpox virus samples are retained by two recognized authorities, one in US, one in Russia Smallpox virus samples are retained by two recognized authorities, one in US, one in Russia No imminent threat of an attack with smallpox No imminent threat of an attack with smallpox

7. What you need to know… Smallpox – The Disease Smallpox – The Disease A serious, contagious, and sometimes fatal disease caused by variola virus A serious, contagious, and sometimes fatal disease caused by variola virus Virus spreads through the air, infected body fluids, contaminated objects such as clothing and bed linens Virus spreads through the air, infected body fluids, contaminated objects such as clothing and bed linens Historically the death rate was 30% Historically the death rate was 30% No specific treatment or cure No specific treatment or cure Only prevention is vaccination Only prevention is vaccination Disease was eradicated worldwide in 1978, general vaccination in US ended in 1972 Disease was eradicated worldwide in 1978, general vaccination in US ended in 1972

8. Smallpox

9. What you need to know… Smallpox – The Vaccine Smallpox – The Vaccine The only effective prevention The only effective prevention Made from live vaccinia virus Made from live vaccinia virus Vaccination site must be cared for very carefully to avoid further spread of virus Vaccination site must be cared for very carefully to avoid further spread of virus Side effects Side effects Provides high level of protection 3-5 years, decreases with time Provides high level of protection 3-5 years, decreases with time

10. What you need to know… Smallpox – The Vaccine cont. Smallpox – The Vaccine cont. Vaccine given by a needle with two points (bifurcated needle) Vaccine given by a needle with two points (bifurcated needle)

11. What you need to know… Needle dipped into a vial of liquid vaccine Needle dipped into a vial of liquid vaccine

12. What you need to know… Skin of upper arm is pricked several times Skin of upper arm is pricked several times Sore spot and small drop of blood form Sore spot and small drop of blood form

13. What you need to know… Smallpox Vaccination Progression Smallpox Vaccination Progression

14. What you need to know… Normal vaccination reactions Normal vaccination reactions

15. What you need to know… Abnormal vaccination reactions Abnormal vaccination reactions Generalized vaccinia Generalized vaccinia Inadvertant inoculation Inadvertant inoculation Death Death

16. What you need to know… When the vaccine virus spreads to other parts of the body, it is known as autoinoculation. When the vaccine virus spreads to other parts of the body, it is known as autoinoculation.

17. What you need to know…

18. Caring for the vaccination site Caring for the vaccination site Cover site with gauze bandage, use medical tape to keep in place Cover site with gauze bandage, use medical tape to keep in place Wear a shirt that covers the site Wear a shirt that covers the site Change bandage every 1-2 days Change bandage every 1-2 days WASH HANDS with soap and water after contact with bandages or touching vaccination site WASH HANDS with soap and water after contact with bandages or touching vaccination site Keep site dry. When showering, cover site with a waterproof bandage or plastic kitchen wrap over the gauze pad Keep site dry. When showering, cover site with a waterproof bandage or plastic kitchen wrap over the gauze pad Put contaminated bandages in sealed plastic bag and throw away Put contaminated bandages in sealed plastic bag and throw away Wash clothing or any other materials that come in contact with vaccine site Wash clothing or any other materials that come in contact with vaccine site

19. What you need to know… Caring for the vaccination site Caring for the vaccination site

20. What you need to know… Smallpox Vaccine – The risks Smallpox Vaccine – The risks The vaccine virus is live and can be spread to other parts of the body, or to other people The vaccine virus is live and can be spread to other parts of the body, or to other people Side effects – normal include fever, soreness, muscle and head aches Side effects – normal include fever, soreness, muscle and head aches Side effects can also be severe, even life threatening Side effects can also be severe, even life threatening Certain groups of people should not receive the vaccine Certain groups of people should not receive the vaccine

21. What you need to know… Who should NOT get the smallpox vaccine Who should NOT get the smallpox vaccine Eczema, psoriasis, atopic dermatitis, burns, open skin conditions Eczema, psoriasis, atopic dermatitis, burns, open skin conditions Weakened immune systems Weakened immune systems HIV positive HIV positive Pregnant, breastfeeding Pregnant, breastfeeding Cancer Cancer Transplant recipients Transplant recipients If you or someone you live with has any of the above conditions, you should NOT receive the vaccine!!!

22. What you need to know… Allergy to vaccine components Allergy to vaccine components Polymyxin B Polymyxin B Streptomycin Streptomycin Chlortetracycline Chlortetracycline Neomycin Neomycin Allergy to previous dose of smallpox vaccine Allergy to previous dose of smallpox vaccine

23. What you need to know… Smallpox Vaccine – The benefits Smallpox Vaccine – The benefits The vaccine offers the best protection available if you are exposed to smallpox The vaccine offers the best protection available if you are exposed to smallpox Becoming vaccinated would fill a critical role within your organizations response team Becoming vaccinated would fill a critical role within your organizations response team

24. Making the Decision… Points to consider: Points to consider: This is a VOLUNTARY program This is a VOLUNTARY program Do you, or any household members, have any of the contraindications? Do you, or any household members, have any of the contraindications? Do you feel capable of caring for the vaccination site properly? Do you feel capable of caring for the vaccination site properly? Do you feel that you can prevent the spread of the virus to other parts of the body or to others? Do you feel that you can prevent the spread of the virus to other parts of the body or to others? Are you willing to accept the small risk of potentially serious side effects? Are you willing to accept the small risk of potentially serious side effects? Are you willing to care for a smallpox patient? Are you willing to care for a smallpox patient?

25. Economic Issues Liability Liability Disability coverage Disability coverage Personal insurance Personal insurance Non-discrimination Non-discrimination Confidentiality Confidentiality