ACIP: vaccinate hospital workers against smallpox: committee decides not to extend the vaccine proposal to all 'first responders'. (Previous Vaccinees to Get Preference).

ATLANTA -- About 510,000 hospital-based health care workers in the United States would receive the smallpox vaccine to prepare for possible bioterrorism, under a new plan recommended by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices at its fall meeting.

About 100 people would be vaccinated at every U.S. hospital that has a negative-pressure room capable of caring for highly contagious patients (about half of U.S. hospitals), according to the plan that must be approved by the Bush administration.

Vaccinees would include emergency room and intensive care nurses and physicians (pediatric and adult), respiratory therapists, radiology technicians, engineers, and consultants in pertinent fields such as dermatology and infectious disease.

Personnel who had previously been vaccinated against smallpox would be the preferred recipients whenever possible.

For now, the committee has decided not to endorse a broader proposal that would have provided vaccine for all "first responders" likely to have contact with an infected patient prior to diagnosis, including emergency medical technicians, police officers, firefighters, and entire emergency room staffs. The health care workers in that group would number from 6 million to 10 million individuals nationwide.

The new recommendation goes far beyond ACIP's June 2002 decision to limit the vaccine to an estimated 15,000-20,000 field investigators and front-line staff at specially-designated "level C" hospitals, where confirmed cases of smallpox would be transported. That plan was deemed insufficient and unfeasible by the Bush administration and by state and local health officials and hospitals.

Although the White House has not yet finalized its smallpox vaccine policy, the shift in its focus to broader use of the vaccine was a result of several factors, Dr. Donald A. Henderson, the federal government's chief advisor on bioterrorism, told ACIP.