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Smallpox vaccine may be harmful
By Amy Menefee
If you have arthritis or a related rheumatic condition that impairs your immune system, think twice about getting the smallpox vaccine.
The Centers for Disease Control and Prevention warned that the vaccine can cause complications, and even death, in people with weakened immune systems.
Some health-care workers started receiving it in January 2003, following President George W. Bush’s mandate that emergency responders be offered the vaccine. Plans call for the United States to vaccinate those who would be on the front lines in the event of a bioterror attack.
This presents a dilemma for health-care workers who already have suppressed immune systems due to rheumatoid arthritis, lupus or other conditions. Such people would be screened out of receiving the vaccination due to their compromised immune systems.
Nursing with lupus
Debra O’Neal, a nursing supervisor in Columbia, Mo., said she is not in a hurry to get vaccinated.
"I’m concerned because of my lupus," O’Neal said. "I don’t react well to the flu vaccines. I’m highly considering whether I should even get [the smallpox vaccine]."
Lupus and rheumatoid arthritis are rheumatic conditions that cause the body to misidentify and attack its own tissues. In addition to weakening the immune system, these diseases can cause inflammation and pain in many areas of the body.
Lupus affects about 1 million Americans, according to the Lupus Foundation of America. Rheumatoid arthritis affects about 2.1 million people. Both diseases affect women more often than men.
O’Neal said she is looking at her decision from several perspectives. "I look at our risk in this area," she said. "We’re not in a huge city. I had smallpox vaccine as a kid, and I’m wondering if any is left."
CDC smallpox facts
According to the CDC, the first dose of smallpox vaccine stays effective for three to five years, and then immunity decreases. If someone receives another dose later, immunity lasts longer. The CDC also reports that the vaccine can prevent or lessen the severity of the disease if administered three to seven days after exposure.
O’Neal said she is reassured by the smallpox vaccine’s quick effect, so she would prefer to wait until an actual outbreak occurred.
That’s what health professionals are recommending, said Bonnie Greene, an infection control coordinator with University of Missouri Health Care in Columbia.
"Those with any immunocompromised state at all should not get it," Greene said. "Unless, of course, there is an event - an exposure."
The CDC recommends that people with weakened immune systems should consult a physician before getting the smallpox vaccine, even if they are exposed to the disease.
Smallpox has entered the national consciousness as a possible bioterrorism agent since the terrorist attacks on the United States in September 2001. The last U.S. case of smallpox was in 1949, according to the CDC, and the disease was deemed eradicated after the last known case in Somalia in 1977. Vaccination stopped after the disease was no longer considered a threat.
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