Smallpox Vaccinations - February 2003

The Orange County Health Care Agency (HCA) is preparing to conduct pre-event voluntary smallpox immunizations in the near future. ("Pre-event" means immunizations that would be given prior to the disease (smallpox) being present in the community.) In preparation for the various "phases" discussed below, HCA is currently providing smallpox education to all HCA employees and assisting the education of employees of hospital, fire department, law enforcement and ambulance providers. In addition, we are meeting with Risk Management, Human Resources, County Counsel and the Orange County Employees Association to ensure that all personnel issues are adequately addressed.

To ensure that we minimize the number of adverse reactions from smallpox immunizations, HCA will be utilizing the screening instrument developed by CDC for all individuals who volunteer for a smallpox immunization in any of the following pre-event phases.

Phase I:

Phase I is designed to immunize public health personnel and hospital workers who have the potential of acting as immunizers in Phase II or Phase III, are needed to perform an epidemiological investigation as part of our public health responsibility, or are needed to provide actual care to patients who have contracted smallpox.

We expect in Phase I to immunize approximately 200 HCA public health personnel and approximately 1000 health care workers at our 26 receiving hospitals that have emergency departments. In addition, we would like to immunize approximately 200 ambulance personnel so that we would have the ability to transport smallpox patients from one location to another if necessary.

We anticipate receiving the smallpox vaccine from the State the week of February 17. We plan to begin smallpox vaccinations for HCA personnel the week of February 24 if we have the concurrence of Risk Management, Human Resources, County Counsel and the Orange County Employees Association and pending receipt and filing of our smallpox plan with the Board of Supervisors (anticipated on February 25th). Hospital and ambulance personnel will be offered the vaccines as soon as hospital administrators and ambulance company owners are satisfied that issues related to liability and patient contact issues have been adequately addressed. We are actively working with hospital administrators and ambulance company owners to determine the actual number of personnel who will volunteer for the vaccination.

Phase I vaccinations have been initiated in Los Angeles County approximately one week ago. To date, only 27 vaccinators have received the smallpox vaccine. They anticipate immunizing approximately 35 Public Health Response Team members this week. The hospitals in Los Angeles County are awaiting further direction on liability coverage before giving their support to Phase I smallpox immunizations for their staff. To our knowledge there have been no adverse reactions to the Los Angeles County Public Health immunizers who have received the vaccinations.

Phase II:

Phase II is designed to immunize fire, law, ambulance, and other health care personnel who may be responsible for responding to people potentially having smallpox. We anticipate that as many as 10,000 vaccines could be given in Phase II. We have not received directions as to when Phase II vaccinations will be initiated.

Phase III:

Phase III is designed to offer the vaccine to the general public. Phase III is not expected to be implemented until sometime in 2004 when the new vaccine becomes available.