SEIU ALERT: New Smallpox Vaccination Risk Factor

For Immediate Release: April 1, 2003 

(Note: Supersedes the Alert dated March 27, 2003)

CDC Recommends Against Smallpox Vaccination for Those with Three or More Heart Risk Factors; More States Halt Program

In light of cardiac problems among 17 health care workers and military vaccinees -- including three fatal heart attacks -- the CDC is investigating a possible link between the smallpox vaccine and these illnesses and deaths.  As a result, at least nine states (AZ,CA,IL,ME,MI,NV,NY,VT,WA) and Los Angeles County have temporarily halted their smallpox vaccination programs.

As an interim measure, the CDC is now recommending that those with a history of heart disease, or those with three or more heart disease risk factors - such as high blood pressure, high cholesterol, and diabetes - not be vaccinated. 

Specifically, the CDC is now recommending those with the following heart conditions NOT to be vaccinated:

• known coronary disease including a previous myocardial infarction (heart attack) or angina (chest pain caused by lack of blood flow to the heart)
• congestive heart failure
• cardiomyopathy (heart muscle becomes inflamed and doesn't work as well as it should)
• stroke or transient ischemic attack (a "mini-stroke" that produces stroke-like symptoms but no lasting damage)
• chest pain or shortness of breath with activity (such as walking up stairs)
• other heart conditions under the care of a doctor

In addition, the CDC is advising potential vaccinees to NOT get the smallpox vaccine if they have 3 or more of the following heart disease risk factors:

• You have been told by a doctor that you have high blood pressure.
• You have been told by a doctor that you have high blood cholesterol.
• You have been told by a doctor that you have diabetes or high blood sugar.
• You have a first degree relative (for example mother, father, brother, or sister) who had a heart condition before the age of 50.
• You currently smoke cigarettes.

You can view this information on CDC’s website at: http://www.bt.cdc.gov/agent/smallpox/vaccination/heartproblems-vis.asp

These new recommendations follow an emergency meeting of the CDC's Advisory Committee on Immunization Practices (ACIP) held on March 28th.  Potential vaccinees should also be aware that the smallpox subcommittee of the ACIP wanted to go even further and restrict vaccination for anyone over the age of 50, but other full committee members thought that would completely undermine the program, and this recommendation was rejected by the full ACIP Committee.

The CDC list of heart disease risk factors fails to mention others raised by the American Heart Association such as being overweight, having a sedentary lifestyle, and drinking more than moderate amounts of alcohol. The American Heart Association’s complete list of heart disease risk factors is available at: www.americanheart.org/presenter.jhtml?identifier=539. 

SEIU suggests that because so many people have heart disease, high blood pressure, high cholesterol, diabetes and other risk factors, and may not know it, it would be prudent NOT to volunteer unless you have been medically screened for, and are certain that you do not have any of these conditions.

Finally, this vaccination deferral for people with heart disease and heart disease risk factors is in addition to a large number of other contraindications for the shot. Because this vaccine contains live virus, the CDC recommends against vaccination for healthcare workers who have or who live in a household with someone or who care for patients who have any of a number of risk factors.

Do not volunteer to get vaccinated if you or members of your household:

·         have a history of heart problems, or have not been screened for, and do not know if you/they have heart disease;

·         have three or more heart disease risk factors, or have not been screened for, and do not know if you/they have three or more heart disease risk factors;

·         have any illness, or are taking any medications (such as steroids) that are compromising your immune system;

·         have HIV or do not know if you/they have HIV;

·         are under treatment for cancer;

·         have skin conditions such as eczema or atopic dermatitis (current or past);   

·         are allergic to certain antibiotics (including polymyxin B, streptomycin, tetracycline or neomycin) used to prepare the vaccine;

·         are allergic to latex products; or

·         are pregnant or considering it soon.

SEIU urges you to learn all you can about this vaccine and its risks. Go to www.seiusmallpox.org to view the CDC factsheet and American Heart Association’s list of heart disease risk factors, as well as SEIU’s smallpox vaccine educational materials: our Checklist, Factsheet, Decision Tree, and Frequently Asked Questions.

Remember, the decision whether or not to be vaccinated is an individual one.  We hope that this Alert combined with information available on our Web site will give you the guidance you need.  If you have questions or any other concerns about the smallpox vaccine, contact your union representative or Bill Borwegen, SEIU’s Occupational Health and Safety Director at BorwegeB@seiu.org or  202-898-3385.