Addressing the Smallpox Threat: Issues, Strategies, and Tools
Slide Presentation by Nancy Ridley
On March 3, 2003, Nancy Ridley made a presentation in the Web-Assisted Audioconference entitled Addressing the Smallpox Threat: Issues, Strategies, and Tools.
The is the text version of Ms. Ridley's slide presentation. Select to access the PowerPoint® slides (1.8 MB).
Smallpox: State Planning and Implementation
Nancy Ridley, M.S.
Assistant Commissioner
Massachusetts Department of Public Health
Slide 1
Massachusetts Demographics
- Small geography and high density.
- 6.5 million residents.
- 351 cities and towns (essentially no counties).
- 76 acute care hospitals (with ERs).
- 7 Emergency Response Planning Regions.
Slide 2
Hospitals by Region
This slide shows a map of the State of Massachusetts. The map is divided into
seven regions: Region 1 West, Region 2 Central, Region 3 Northeast, Region
4a Metro North, Region 4b Metro South, Region 4c Boston, and Region 5 Southeast.
Below the State map is a listing of hospitals located in each region.
Slide 3
Smallpox Planning Massachusetts
- Statewide Smallpox Workgroup.
- Pre-event plan
- Phase 1 A – 7,600 hospital staff
- 100 staff X 76 hospitals.
- Phase 1 B – 2,400 community response team personnel
- 16 member teams…. Medical, EMS, 1st responders.
- 150 members X 7 regions to be vaccinated to ensure 24/7
coverage.
- Phase 2 (maybe).
Slide 4
Smallpox Pre-Event Planning Massachusetts
Phase 1A and 1 B:
- Immunization of 10,000 volunteer HCWs, public health workers and first
responders
- Previously vaccinated.
- Careful screening of volunteers and household contacts for contraindications.
- Extensive follow-up for adverse events.
- No furloughs.
Slide 5
Smallpox Pre-Event Planning Massachusetts (cont.)
Phase 1A/B:
- State public health response team (DPH staff).
- Multidisciplinary teams at 76 hospitals.
- 7 regional response teams.
- Capacity building
- PH nurses.
- School nurses.
- Visiting Nurses Associations.
Slide 6
Smallpox: Pre-Event Planning Massachusetts (cont.)
- Vaccination of DPH staff will begin February 12th.
- Phase 1 A vaccination (hospitals)
- Phase 1 B vaccination (response teams)
- 12 weeks – completion (<6 months).
Slide 7
Vaccination Process
- Hospital Response Teams:
- DPH vaccinates 10 core state public health staff.
- 50 additional DPH staff, plus Boston and Cambridge health department
staff vaccinated.
- Once vaccine "takes" confirmed (~ March 1), these 60 vaccinees
will begin vaccinating the "vaccinators" in each of
the 76 hospitals.
- Community Response Teams:
- Vendor operated vaccination clinics.
Slide 8
Smallpox: Phase 2
- Eventual vaccination of all health care workers and first responders.
- Massachusetts estimate = approximately 120,000 individuals.
- No official announcement from Federal government.
- Will be based on lessons learned from Phase 1.
Slide 9
Smallpox: Controversial Issues
- Liability.
- Worker compensation (vaccinee, secondary contacts).
- Malpractice coverage.
- Health insurance coverage for side effects.
- Furloughs.
- Unions (police, fire, nurses, etc.).
Slide 10
Controversial Issues (cont.)
- Vaccine safety (Israel's Lister v. New York Board of Health strains).
- Safety of needles.
- Municipal v. private first responders.
- Dissemination of training materials.
- Sustainability of State bioterrorism initiatives.
Slide 11
Pre-Event vs. Post-Event Planning
- Pre-Event:
- Plan to deal with one suspected case of smallpox in Massachusetts.
- Post-Event:
- Plan to vaccinate the entire population within 4 days regardless of
an actual smallpox case in Massachusetts.
Current as of July 2003
Internet Citation:
Preparedness Issues for the Local Level. Text Version of a Slide Presentation at a Web-assisted Audioconference. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/smpoxtele/sess1/ridleytxt.htm
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