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)
  • 10-12 weeks.
• 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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