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IMMUNIZATION -- Our Front Line Defense?

In the 18th Century, smallpox was so deadly that almost half of those contracting the disease died. The disease was most lethal in children and the elderly, but some adults seemed to have relatively milder symptoms from the disease.

The breakthrough for effective prevention of smallpox came in 1796 through an Englishman named Edward Jenner. Jenner was a physician who practiced as a country doctor. Smallpox ran rampant during most of the eighteenth century and was a major plague in Europe. It was a highly contagious disease. Its victims had symptoms similar to the flu. However, with smallpox, the victims would develop a rash of odorous, pus-filled blisters all over their body. The blisters would then turn into crusty scabs, would fall off and leave the victim's body scarred. This disease also lead to blindness, pneumonia, and commonly, death.

One day, Dr. Jenner overheard a girl say that she could not get the dreaded smallpox disease because she had already had another disease known as cowpox. This remark stuck with Dr. Jenner and he subsequently moved to London where he researched and experimented with the cowpox disease for several years. He found out there were actually two forms of cowpox, but only one form could possibly provide a human body with an immunity to smallpox.

On May 14, 1796, a milkmaid named Sarah Nelmes visited Dr. Jenner for the treatment of cowpox. Dr. Jenner decided it was time to test his vaccination, and he tested it on his gardener's son, an eight-year-old boy named James Phipps. The boy did contract cowpox, but he recovered from it within a few days. Dr. Jenner then waited eight weeks for the boy's body to build an immunity. To complete his experiment, Dr. Jenner exposed James to smallopx. Amazingly, the boy did not contract the deadly disease, and the doctor claimed success.

The medical community turned its back on Jenner's claims, and it refused to even listen to him. Finally, he got his big break when a similar experiment in London with cowpox and smallpox proved that Dr. Jenner was right.

Before Jenner's discovery, the standard means of protection against smallpox was inoculation - deliberately infecting a healthy person with matter from someone suffering from a "mild attack" of smallpox. Usually this resulted in the inoculated person also suffering a mild infection, which then gave immunity against future more virulent attacks. But it was a risky procedure. Sometimes the resulting infection was not mild at all, but fatal.

The word "vaccinate" is derived from "vacca" -- the Latin word for cow. The vaccinia virus used today to immunize humans against smallpox is a variant of the common cowpox virus initially used by Jenner. It is presently only given to certain laboratory workers who might become exposed to smallpox in their work. The vaccinia strain is believed to be effective against the generic smallpox disease but there has been growing doubt that it will be effective against the smallpox strains (India 1, for example) developed for weaponized use. Information about this is difficult to obtain since most of this work is classified and secret. If the vaccinia vaccines are effective, which is presently not certain, the next question is who will get the vaccine if it is used by terrorists?

The New York Times has reported that the CDC plans to increase the number of "first responders" who receive the vaccination to 500,000 from the agreed-to 15,000. Preparations are also underway for rapid mass vaccination of the general public. The more extensive vaccination plan is possible because supplies are increasing. The government spent more than $780 million to develop its present vaccination arsenal.

In addition to "medical first responders," it has been suggested that first responders should also include a class to be defined as "economic first responders," those who would be necessary in keeping the economy moving in the event of a nationwide "lock down" caused by an outbreak.

This group would include pilots, truck drivers, food handlers, etc. It is the "etc." that is of concern. Where do you draw the line? Obviously, the line will be drawn after Tommy Thompson's vision of a "vaccine for every man, woman and child" has been fulfilled. One of the major problems is the lack of vaccinia immune globulin (VIG), the "antidote" that is needed for those who experience a severe reaction to the vaccine. The Times article reports that there are only 700 doses currently available. Dr. Tom Mack, among others at the CDC warned that, "in the absence of VIG, extensive vaccination would be extremely dangerous."

The vaccinia virus used in the vaccine has been known to cause encephalitis and other neurological problems, including death, in a portion of those given the vaccine. In fact, history shows that immunization has caused many problems in the past.

The worst smallpox disaster occurred in the Philippines after a 10 year compulsory US program administered 25 million vaccinations to its population of 10 million resulting in 170,000 cases and more than 75,000 deaths from "smallpox", in a country having only scattered cases in rural villages prior to the onslaught of vaccines.

Another worry is the fact that infected people may rush to a hospital where they could expose many otherwise sick patients and staff. Since there is no real treatment other than isolation, it has been suggested that traditional medical facilities could become a major source for spreading this disease. This point has not been widely discussed and health officials worry that the public will need to be given special instructions to "stay at home" and "remain indoors."

In the end, the public may have to make the final decision whether to be immunized, re-immunized, or to take their chances with the new world order we have created.

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