Bioterrorism Preparedness Program

Smallpox Preparedness

- Health Care Provider Alert -

Smallpox Vaccination Reminder

 16 May 2003

On Friday, December 13, 2002, President Bush announced a voluntary smallpox vaccination program that targets approximately 1,200 health care workers, public health workers, and public safety workers in Rhode Island.  In response the RI Department of Health asked all acute care hospitals in the state to identify employees who would be interested in serving on the hospital’s health care smallpox response teams.  These teams will care for the first suspected patients if a smallpox outbreak occurred and until other hospital employees could be vaccinated.  

HEALTH now announces the opening of the state sponsored RI Vaccine Clinic at Eleanor Slater Hospital in Cranston beginning Thursday, May 15, 2003.  The RI Vaccine Clinic will be open on Tuesdays and Thursdays from 10:00 a.m. to 2:00 p.m. and will initially provide vaccinations for only volunteer hospital employees.  Vaccinated persons will be carefully screened, vaccinated and then monitored in the workplace on a daily basis by hospital based “site care clinicians” to document integrity of dressing, reinforce infection control practices, read “takes”, and recognize, refer and report adverse events.   It is expected that all vaccinated persons will have received instructions to contact the clinic site where they were vaccinated should they have questions, become ill or need medical attention related to their vaccination.  However, it is still possible that in the course of your practice you may encounter recently vaccinated individuals for issues related to their vaccination, or encounter them for other routine care. Each vaccinated person is instructed to carry on their person a vaccine diary as well as a vaccine card with phone numbers for 24/7 access to specialty care for their vaccine issues.

INFECTION CONTROL ISSUES:

• Smallpox vaccination produces a skin lesion, which is infectious.  Vaccine virus in the skin lesion can be transferred to others if the skin lesion is touched directly or if the bandage is handled casually with ungloved hands.  The vaccination site is infectious until the scab falls off, approximately 21 days after vaccination.  The vaccine site is usually the left deltoid area and will be covered with a dressing.  Touch such lesions only with gloved hands.   If you touch an active vaccination site or the bandage covering it with ungloved hands, wash your hands with soap and water, or with one of the alcohol-based handwash solutions.  In case of encounters with unconscious patients with lesions search for a vaccine card or diary on their person, for documentation. 

ADVERSE EVENTS:

• As needed, HEALTH suggests consultation with an infectious disease expert or infection control practitioner at your institution for routine questions on individual patients, as you would for any other infectious disease issue.
• If complex issues arise or serious adverse events are suspected, report the case immediately to HEALTH at 401 222 2577 (day), or the on-call number 401 272 5952 (after hours).  HEALTH has protocols to mobilize in-state and Federal specialty consultation, lab testing and access to drugs as needed.

It is important that practitioners learn the basics about smallpox vaccination, normal reactions and adverse events.  Extensive training resources including images can be found at:

www.bt.cdc.gov/training/smallpoxvaccine/reactions/default.htm

HEALTH contact for RI Vaccine Clinic issues: Kathy Cullinen (Program Coordinator) at 222 3497 or kathyc@doh.state.ri.us