By Madhu Krishnamurthy
Daily Herald Staff Writer
05/24/03

Federal terror threat warnings may have placed the country on a heightened level of alert, but bioterrorism preparedness is taking a toll on area health departments.

Health officials in Lake and other counties are grumbling about the time, money and resources they were required to put into preparing for smallpox vaccinations, mandated by the federal government, only to watch the program fizzle out.

Officials say they would have better used those resources elsewhere, such as for fighting West Nile virus and tuberculosis.

"This is a federal debacle that now could be written as a local public health failure," Lake County health department Executive Director Dale Galassie told board of health members earlier this month.

Lake County held its second and final smallpox vaccination clinic Thursday with poor turnout.

"We were expecting three people, but due to medical reasons none were vaccinated," spokeswoman Leslie Piotrowski said. "There won't be any more clinics."

The county health department vaccinated eight health workers, four of its own staff and four from Advocate Good Shepherd Hospital in Barrington. The logistics alone of organizing clinics created a management headache. The county spent about $25,000 on staffing and equipment in the effort.

"It was a big pain to set up," said Bill Mays, director of community health services. "Not every site is suitable for an immunization clinic of that type, and it took quite a bit of staff time and effort to identify the sites."

Many counties have spent thousands of dollars in planning for smallpox vaccinations with little to show for it.

"The DuPage County Health Department has not given one smallpox vaccination yet," said Leland Lewis, executive director. DuPage spent several hundred thousand dollars for its program with zero help from state or federal agencies.

Counties were initially told to use funds from bioterrorism grants already earmarked for other purposes. But now it seems they might receive some federal aid.

The U.S. Department of Health and Human Services announced earlier this month it would allocate $100 million to assist states with their smallpox vaccination programs.

"Because a smallpox attack is possible, we must prepare our public health workers to quickly respond to protect the American public," Health and Human Services Secretary Tommy Thompson said in a prepared statement.

However, there's been no word yet when that funding will be available, state health department spokeswoman Jena Welliever said.

"Once we receive that, we'll know what it can be used for and how it can be allocated," she said.

Meanwhile, local health departments will have to make do with what resources they have.

Some health officials are taking the matter in stride.

"Whether we wind up vaccinating a lot of people or not is kind of moot because we did really learn from the experience," said Kitty Loewy, director of communications for the Cook County public health department. "It has given us some perspective."

Cook never really got its program up and running and has a clinic scheduled for mid-June. Interest in participation has not been what officials anticipated.

Officials expected to vaccinate about 1,200 health workers in suburban Cook County.

"That was an optimistic figure," Loewy said. "We don't have more than 10 people total interested in being vaccinated. A lot of hospitals decided to not participate right now."

That's because in March vaccinations were halted nationwide due to heart problems caused by the vaccine in a few volunteers elsewhere in the country, some resulting in death. All clinics were held in limbo until the Centers for Disease Control and Prevention issued new guidelines for vaccinations. The directive states people with heart problems cannot be vaccinated.

The biggest issue is screening people to see if they are eligible to take the vaccine.

"The screening part of the clinic is especially intense because of the volatility of the vaccine ... because it's so prominently associated with adverse effects," Mays said.

That not only affected the number of volunteers willing to take the risk, but raised issues of accountability.

"I wouldn't allow any smallpox vaccination to be given by my staff until I knew that they were personally protected from the liability standpoint," Lewis said. In most counties, volunteers are protected under the worker's compensation law.

DuPage has a smallpox clinic scheduled for Thursday. Lewis said he's not second guessing the federal mandate but wants to see some funding for the program in the near future.

"When you have to pull staff to work on bioterrorism you can't do the things that you're supposed to be doing," Lewis said. "Something has to give. You have to give up some of the basic public health services, and that's our dilemma."