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CDC releases smallpox vaccination plan

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Document: Smallpox Vaccination Clinic Guide  (PDF -- Adobe Acrobat required)external link
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ATLANTA, Georgia (CNN) -- Federal health officials have put together guidelines for vaccinating within five days the entire U.S. population against smallpox in case of a bioterrorist attack.

The Centers for Disease Control and Prevention sent a manual to all 50 states and Washington, D.C. Monday with instructions on how to vaccinate entire populations within a week of an outbreak.

Only scientific research centers in the United States and Russia are known to have the smallpox virus, but federal officials are concerned terrorist groups might obtain the virus and release it in the United States. The virus could kill up to 30 percent of those infected.

Called the Smallpox Vaccination Guide, the CDC manual states that in the event of an outbreak, rapid vaccination "may be required" to stop the virus from spreading.

However, it calls for the vaccinations to be voluntary. "Current smallpox vaccines are available under an investigational new drug protocol only, and informed consent must be obtained," the manual said.

In a teleconference Monday, the CDC said anyone who refused to have the vaccine would be "closely monitored" by doctors.

Nuts-and-bolts guidance

The manual explains how vaccines would be made available to states, and also calls on states to establish large vaccination sites and isolated places to take people who may have contracted the virus. As many as 75 million doses of the vaccine could be shipped in a single day.

The CDC document gets into some of the nuts-and-bolts that such a large operation would entail, including how many people should work at each clinic; which supplies would be needed; how to inform the public of vaccination plans; and how people with various health conditions might be affected by the vaccine.

It also says that those who will work at the clinics should be vaccinated in order to protect against exposure.

The clinics would also need a good deal of security, the manual says, with only "locked, limited access" to the vaccine.

The government has chosen not to vaccinate the U.S. population unless there is an attack, because the vaccination also carries dangers. If the entire population were to receive the vaccine, an estimated 300 to 350 people could die.

But federal officials are not saying how many cases of smallpox it would take to put the vaccination plan into action. The CDC said that if a single case of smallpox is found, federal, state, and local health officials will discuss the situation and determine how to proceed.

Beefing up past plan

The manual is an updated version of a smallpox response plan the government first released last November. The previous version called for "ring vaccination," in which health officials would vaccinate people in the area surrounding the site of an outbreak, then steadily work their way outward.

The rapid national vaccination strategy in the version released Monday will be a "complement" to ring vaccination, the CDC said.

The plan would cost between $5 and $10 per person, an expense to be picked up by local health departments.

Health officials have enough vaccine for 155 million people, more than half the U.S. population. By the end of the year they expect to have enough for all 288 million Americans.

If there were an outbreak of smallpox before the end of the year, health officials said, they would still be able to obtain enough vaccine.

The White House is considering whether to vaccinate certain people, such as health officials who may be the first to respond to an outbreak.

The government used to routinely vaccinate children, but stopped in 1971. It is not known whether those who received a vaccine before that time would be protected against the virus.

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