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DoD Works to Better Educate Healthcare Workers on Vaccines

By Sgt. 1st Class Kathleen T. Rhem, USA
American Forces Press Service

WASHINGTON, Nov. 5, 2001 – Military allergy and immunization specialists have worked hard to educate healthcare providers on vaccine safety. But in light of rising bioterrorism concerns, they've ratcheted up their efforts.

Army Dr. (Col.) Renata Engler is the medical director of the Vaccine Healthcare Center Network, which recently opened its first center here at Walter Reed Army Medical Center. She explained that vaccines are tools to protect DoD's members, but they also need to be afforded the same care, respect and safety precautions given other prescription medicines.

DoD and the Centers for Disease Control and Prevention in Atlanta became partners this summer to provide a network of clearinghouses for information on vaccine safety and procedures throughout DoD.

The new initiative was in response to "the growing challenges that have arisen in the context of immunization healthcare," Engler said, particularly concerning the public controversies surrounding immunization safety in general as well as the DoD Anthrax Vaccine Immunization Program specifically.

"Knowledgeable resources had to be developed to support the providers and the small outlying immunization clinics who are dealing with the challenges and to support special, complex patient issues that local medical facilities might not be resourced to handle," she said.

Engler said her work has come into a whole new light in the aftermath of Sept. 11 -- the contamination of the mail with anthrax has made the threat of bioterrorism clear to Americans.

She said her organization has been involved in developing plans for possible new or changing vaccination programs for service members.

Any possible use of smallpox vaccine is of particular concern, since America's stockpiles of vaccine for this deadly, disfiguring disease are old and were made with outdated technology, experts have said. Engler and her staff are consulting with various agencies to work up contingency plans in case experts decide there's a need to vaccinate Department of Defense as well as emergency response personnel against smallpox, she said.

"There are some concerns about adverse events related to that vaccine," Engler said. "We've gotten busier faster than we wanted to in response to new bioterrorism threats that are arising." But this is why the organization was created in the first place.

"The Vaccine Healthcare Center is really a resource to address the need for outreach education in this rapidly changing world of immunization challenges," Engler said. "We need to do everything we can to give the right shot to the right person at the right time in the right way."

She said service members 20 years ago received "a handful" of vaccines, but now routinely take more than 50 shots during their careers. And another 30 vaccines are at various stages of the developmental pipeline and may be introduced into the immunization requirements over the next five years.

Adverse reactions and drug reactions occur in 1 percent to 2 percent of people with any drug, Engler said. That small percentage, she noted, can mean big problems in a large enough population.

"That's 20,000 to 40,000 people in a population of 2 million," she said. "Improving our understanding of rare adverse events would enhance vaccine safety surveillance and lead to higher quality immunization healthcare delivery overall."

The Vaccine Healthcare Center Initiative began in September and is scheduled to expand to include several regional centers in the future. Several more are set to open in regional DoD medical centers in the United States in 2002, leading up to a total of 15 regional centers by 2006, Engler said.

"These vaccine healthcare centers would work as a network to share information, not just internally but with the Food and Drug Administration, CDC, and the Vaccine Adverse Event Reporting System, too, as questions arise surrounding a vaccine," she said.

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