Smallpox Campaign Taxing Health Resources

As they rush to answer President Bush's call to vaccinate 10.5 million medical workers and emergency responders in a matter of a few months, state and local health officials say they have stopped virtually all other counterterrorism efforts and in many cases they have begun trimming services such as AIDS prevention, prenatal care, water testing and tuberculosis tracking.

In Seattle, the health department is belatedly scrambling to control an alarming surge in STDs. "We would have been on this faster and more effectively if I could have put a critical mass of infectious disease people on this rather than on smallpox," said Alonzo Plough, director of the Seattle-King County Department of Public Health.

About half of 539 health departments surveyed "deferred, delayed or canceled" more traditional projects such as flu vaccinations for the elderly, STD clinics, and check-ups for low-income children, according to a National Association of County and City Health Officials report released last month.

Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy, said it is common for public health departments to shift staff and priorities during crises. "The issue here is that it not last for months and months," he said. "Then it becomes more of a problem." CDC officials overseeing the smallpox campaign sympathize with their local partners. Almost all of the 350 people in CDC's immunization division are assigned to the smallpox program, said Director Walter Orenstein.

Jumping from the first stage of inoculating 500,000 health workers to the second stage, when 10 million police, fire and medical personnel will be offered vaccine seems overwhelming to many health experts. In Georgia, "Phase 2" could involve immunizing 100,000 people, said Georgia Division of Public Health Director Kathleen Toomey, and "we would be having to shut down other public health activities." At present, Toomey noted, "Almost 90 percent of my time is devoted to homeland security. It's difficult for other programs to not have the leadership of the commissioner."

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