Leaders of the state's two largest health-care unions yesterday urged their members not to volunteer for smallpox vaccination, saying the government's plan endangers health-care workers, their families and their patients.
Linda McDonald, president of the United Nurses and Allied Professionals, which represents workers at Rhode Island Hospital and elsewhere, said the plan to vaccinate 1,200 health-care workers in Rhode Island is "hasty and ill-conceived" and "may do more harm than good."
She was joined at a news conference by leaders of Local 1199 of the New England Health Care Employees Union, which represents workers at Women & Infants Hospital and many nursing homes.
With their announcement, the local unions followed in the footsteps of the Massachusetts Nurses Association, the Bay State's largest nurses' union, which on Tuesday urged its members to avoid smallpox vaccination until safety and liability concerns are addressed. Additionally, the medical staffs at some 80 hospitals around the country have declined to participate.
Union officials yesterday pointed out there is no immediate threat of smallpox, which has been eradicated, but the vaccine can make people ill.
Federal officials, however, fear that misplaced laboratory stockpiles of the virus could be used in an attack. They want health-care workers to be vaccinated so they can care for the sick if that happens.
"We do feel that this is being rushed," McDonald said. "Should there be a significant threat from an actual [smallpox] case, you have plenty of time to immunize the population."
The union officials raised these concerns:
That people vulnerable to the vaccine's ill effects will get vaccinated.
That the screening process will not be kept confidential.
That patients may get sick from contact with vaccinated workers, because the vaccine contains a live, infectious virus.
That workers will face discrimination at work if they decline the vaccine.
That employees will face medical costs and loss of income if they become ill.
That the needles used for the vaccine will transmit HIV.
Rhode Island's health director, Dr. Patricia A. Nolan, said the Health Department shares the unions' concerns and is working to address them. She emphasized that the program is voluntary and that the state's smallpox preparedness plan can proceed even if no one steps forward to be vaccinated in advance.
"We believe we've really taken the steps that are necessary to control the risk of a bad outcome," Nolan said, noting that an extensive screening effort should keep vulnerable people from being vaccinated.
"I am not urging people to get vaccinated or not get vaccinated," she added. "I'm working hard to put the very best information in the hands of that group of health-care workers who would be our frontline if we ever had a case of smallpox, and let them make that decision."
Nolan said that it is "really unlikely" that patients would get infected from contact with vaccinated health-care workers, as long as the blister or lesion left by the vaccine is cared for properly.
"There could be particular situations in which hospitals could decide not to have people working in certain jobs with certain patient population while they have an active lesion," she said.
The bifurcated needle used to administer the vaccine is less likely than standard needles to transmit HIV because it's not hollow and does not draw blood into it, Nolan said. Additionally, everyone getting the vaccine will have to show they don't carry HIV.
But she acknowledged that it is not clear who would pay for the care of people who become seriously ill or who would be responsible for compensating them. That is one risk that health-care workers will be made aware of before they get the vaccine, she said.
If there were a smallpox case, health-care workers could get quickly vaccinated, Nolan said. But they might be exposed to smallpox before the vaccine takes.
Nolan also said that far from rushing, the Health Department is proceeding at a deliberate pace. It has just started recruiting volunteers and has not set a date for any vaccinations, although the first group of about 30 volunteers may get vaccinated during the first week of next month.
In the fall, she acknowledged, the Health Department was under great pressure to quickly get its smallpox plan to the U.S. Centers for Disease Control and Prevention. "Since that time," she said, "I have not felt that same kind of time-pressure issue."
Read more about the R.I. Health Department's plans for voluntary smallpox vaccination and for dealing with the threat of smallpox, at:
http://www.healthri.org/environment/biot/smallpoxprepare.htm
