Q. Why does the New Jersey Department of Health plan to vaccinate volunteer hospital and public
health workers for smallpox?
A. As part of a federal Homeland Security program,
the Centers for Disease
Control and Prevention (CDC) asked all states to submit a plan
to vaccinate volunteer first-line healthcare workers and public
health workers against the smallpox virus to defend against the
potential for a bioterrorism attack. New Jersey submitted its
plan for this first stage to the CDC December 9, 2002 and it was
approved in early January 2003. The plan for Stage 1 vaccinations
in New Jersey is consistent with the New Jersey Department of Health (NJDOH) Terrorism and Public Health
Emergency Preparedness and Response Plan.
Q. According to the New Jersey Smallpox Vaccination Plan, who
will be immunized first?
A. The first group of people who will be vaccinated
are volunteer public health workers who, in turn, will be able
to vaccinate other health care workers in the future. We also
plan to vaccinate public health response team members and hospital
health care response team members.
Q. Who are on the Public Health Response Teams?
A. The Public Health Response Teams will be comprised
of, but not limited to, a physician team leader, epidemiologist,
public health nurse/vaccinator, a lab worker, law enforcement
agent, regional planner/coordinator, a LINCS (Local Information
Network Communication System) planner/coordinator and an industrial
Q. Who are on the Hospital Health Care Response Teams?
A. Hospital health care response teams will be
comprised of, but not limited to, emergency physicians, infectious
disease physicians, emergency department nurses and general nursing
staff, infection control practitioners, and ancillary and security
Q. What will these teams do?
A. The Public Health Response Teams will be deployed
to hospitals to investigate a high-risk or confirmed patient with
smallpox, identify potential contacts, collect clinical specimens,
and ensure safety precautions are maintained. The Hospital Health
Care Response Teams will provide direct patient care and ensure
that proper infection control procedures, personal protective
equipment and security are available. In the event of a smallpox
outbreak, these teams will help treat and contain the disease.
Q. How credible is the smallpox threat to New Jersey?
A. At this time, the worldwide threat is uncertain.
However, the New Jersey Department of Health
recognizes that it is prudent to acknowledge the possibility of
the threat and prepare to protect New Jersey citizens in accordance
with the federal plan. The Department will rely on receiving additional
updated information from law enforcement and federal and state
Q. Where will vaccination clinics be located?
A. The Department has identified seven clinic
sites. They will be in five regions (northeast, northwest, central
east, central west, and south) and one in Newark, an MMRS site
(Metropolitan Medical Response System). The southern region clinic
will alternate between two locations. Department of Health staff will be assigned to each clinic location.
Q. How many people can be vaccinated in a day?
A. Initially, in the vaccination preparedness
program, each clinic will be able to vaccinate up to 720 individuals
per day. Each regional clinic will operate about one day a week
for four weeks.
Q. How many doses of vaccine does New Jersey
A. The Department of Health
has received 5,000 doses of the 9,500 approved does of vaccine
from the federal Centers for Disease Control and Prevention (CDC)
for the Stage 1 preparedness program.
Q. Why is the number of vaccines less than the 15,000 New Jersey
A. New Jersey presented an aggressive plan to
the CDC to have treatment teams available in every acute care
hospital plus investigation teams of public health workers. The
CDC provided enough vaccine for New Jersey to begin its preparedness
program. The number of volunteers allows for adequate treatment
teams in the event of an outbreak.
Q. When will the smallpox vaccine be administered?
A. Vaccines for volunteers among public health
and hospital workers began January 31, 2003 and will continue
through the first week of March.
Q. Is there enough smallpox vaccine for everyone?
A. There is enough licensed vaccine available
at this time to vaccinate volunteers in the Stage 1 vaccination
preparedness program (i.e., public health and hospital response
teams). The federal government does not recommend vaccination
of the general public at this time.
to the information received from CDC, there will be enough vaccine
to inoculate the entire country within the next 12-16 months.
Q. Is there a cure for smallpox?
A. There are medications that can be used for
supportive care (i.e., to treat the symptoms of smallpox). However,
there is no "cure" for smallpox, and it cannot be treated
Q. Are there side effects to the smallpox vaccine? How safe is
A. There are side effects and risks associated
with the smallpox vaccine.
Some people experience normal, usually mild reactions that include
a sore or swollen arm, fever, and body aches. However, other people
experience reactions ranging from serious to life threatening.
Q. Who are most likely to have serious side
effects from the vaccine?
A. Serious side effects are most likely to occur
in people who have now or in the past have had, even once, skin
conditions, especially eczema or atopic dermatitis, and people
with weakened immune systems, such as those who have received
a transplant, are HIV positive, are receiving treatment for cancer,
or are currently taking medications (like steroids) that suppress
the immune system. In addition, women who are breastfeeding or
pregnant women should not get the vaccine at this time because
of the potential risk it poses to the baby or unborn fetus. And
people under 18 years of age and those allergic to the vaccine
or any of its components should not receive the vaccine at this
Q. How many people get side effects after being vaccinated?
A. In the past, about 1,000 people for every 1
million people vaccinated for the first time experienced reactions
that, while not life-threatening, were serious. These reactions
included a toxic or allergic reaction at the site of the vaccination
(erythema multiforme), spread of the vaccinia virus to other parts
of the body and to other individuals (inadvertent inoculation),
and spread of the vaccinia virus to other parts of the body through
the blood (generalized vaccinia). These types of reactions may
require medical attention. In the past, between 14 and 52 people
out of every 1 million people vaccinated for the first time experienced
potentially life-threatening reactions to the vaccine. Based on
past experience, it is estimated that 1 or 2 people in 1 million
who receive the vaccine may die as a result. Careful screening
of potential vaccine recipients is essential to ensure that those
at increased risk do not receive the vaccine.
Q. How many people have been vaccinated so far?
A. Some laboratory technicians, the federal public
health response team, and groups in clinical trials related to
production of Vaccinia Immun Globulin (VIG-for treatment of severe
side effects) have been vaccinated.
I go to my doctor and get vaccinated against smallpox?
No. The federal government does not recommend vaccinations for
the general public at this time. Vaccine will be distributed on
a limited, secure basis to state health departments.
Can a hospital or person be held liable for injuries to a volunteer
who has a severe reaction to the vaccine?
Section 304 of the federal Homeland Security Act provides an exclusive
remedy against the United States for injury or death attributable
to smallpox vaccine, other substances used to treat or prevent
smallpox, or vaccinia immune globulin ("smallpox countermeasures").
This means that no claim for liability for injury or death attributable
to a smallpox countermeasure could be brought against entities
or individuals who are covered by Section 304's protections. This
volunteers who receive the vaccine, hospitals in which they work,
and people who administer the vaccine.
Q. When do the provisions of Section 304 become effective?
The effective date, as established in the Homeland Security Act,
was January 24, 2003.
Are volunteers who suffer severe reactions to the smallpox vaccine
entitled to worker's compensation?
Yes. NJDOH will register volunteers for the preparedness program
with the Office of Emergency Management and those people will
be eligible for state workers compensation for prolonged reactions.
Those employed by institutions, such as hospitals, will be covered
by their institution's worker's compensation carrier.
in rare circumstances, reactions to the vaccine are mild. Screening
for contraindications will help prevent giving the vaccine to
volunteers who may be at risk or who come in regular contact with
someone who could be at risk.