The Bush Administration is asking front line hospital workers to volunteer to be vaccinated against smallpox. No smallpox disease has occurred anywhere in the world for 25 years.

 Fact # 1: The decision to be vaccinated is strictly Voluntary.

• As a health care worker, you likely will be among those asked to volunteer.
• The decision you make will affect you, your patients and your family.
• The decision whether or not to be vaccinated is yours alone.

 Fact # 2: Smallpox vaccination carries significant risks.

The vaccine infects you with "live" vaccinia virus, a weaker "pox" type virus, that protects you against smallpox.

• Vaccinia virus is not the smallpox virus and cannot give you smallpox.
• The vaccine is effective in preventing the disease; in fact you have a 90% chance of preventing the disease if you are vaccinated within four days after exposure.
• This vaccine has been described as the "least safe human vaccine."

It can cause severe reactions, complications and even death.

• Because the vaccine contains live vaccinia virus, it can spread to other parts of your body or even infect family members, co-workers and possibly patients.
• 15 out of every 1 million people vaccinated for the first time will face life-threatening complications.
• Many more will suffer from fever and swollen lymph nodes.
• One third of those vaccinated become sick enough to miss at least one day of work.
• Severe side effects usually appear within three weeks.
• One or two people out of every 1 million people vaccinated will die.

Reactions to the vaccine are less common for those being revaccinated.

• Volunteers who were vaccinated for smallpox in the 50s, 60s or early 70s should have fewer reactions when they are revaccinated, but reactions can still be severe.
• It is not clear whether those who were previously vaccinated still have immunity, as it is believed that booster shots are needed every five to 10 years.

Don’t volunteer to get vaccinated if you have any of these conditions or live in a household with someone who has any of these conditions:

• HIV, or do not know if you have HIV;
• cancer or any other medical conditions that compromises your immune system;
• skin disorders such as eczema or dermatitis (current or past);
• allergies to certain antibiotics used with the vaccine;
• allergies to latex products;
• a medical need to take high doses of steroids; or
• pregnancy or are considering it soon.

Before you volunteer to be vaccinated, find out about the following protections:

• a training and education program that includes the opportunity to ask questions;
• free, on-the-clock counseling to help you decide whether you should be vaccinated;
• medical screening and free and confidential medical testing to ensure you and members of your household have no conditions--such as HIV infection, pregnancy, antibiotic allergies, eczema and other skin disorders--related to adverse vaccine reactions;
• an understandable informed consent form;
• plans for on-site daily monitoring and care of the vaccination site and tracking and reporting of complications;
• a plan to protect immune-compromised patients from recently vaccinated health care workers;
• clear policies concerning coverage of lost work time for vaccination-related illnesses;
• compensation for personal, family and patient medical costs caused by vaccine complications;
• a clear written policy that health care workers will not suffer discrimination for refusing to participate in any smallpox vaccination program; and
• an agreement to use safer vaccination needles with integrated safety features as required by the federal Needlestick Prevention and Safety Act of 2000.

Adapted with permission from an Service Employees International Union factsheet.