Dear Doctor Column, November 5, 2001

Question:

Why can't I get a smallpox vaccine? What about anthrax vaccines?

Answer:

There is no need to be vaccinated against smallpox at this time. The last naturally occurring case of smallpox was reported in Somalia in 1977, and in May 1980, the World Health Organization certified that the world was free of the disease. In fact, the smallpox vaccine has not been manufactured or available commercially in the U.S. since 1972, when routine vaccinations against smallpox were discontinued. However, the U.S. Public Health Service maintains an emergency stockpile of smallpox vaccine that can be distributed if the need arises.

Anthrax vaccination is not available to, or needed by, the general public. Most recently, the vaccine has been administered only to military personnel at high risk for potential exposure to anthrax in combat settings. Vaccine production was stopped a year ago because of manufacturing problems that are now being remedied, and a new anthrax vaccine is being developed under a defense department contract.

Prior to the recent isolated incidences, the last confirmed case of human anthrax reported in the U.S. was in 1992. Government officials stress that the U.S. is not experiencing a national outbreak of anthrax and that the number of confirmed cases occurring in the past few weeks has been limited to a few sites. There have been no document cases of anthrax or anthrax exposures in Alabama. (Note to Editor: We will let you know if we are notified about one before publication.)

If additional outbreaks should occur, there are several antibiotics that can prevent or treat the disease, if taken early. People do not need to have these antibiotics on hand. U.S. public health authorities have a large supply of antibiotics in warehouses and millions of doses that are packed and ready for delivery within hours to appropriate sites.

While anthrax has grabbed the nation's attention, don't overlook a far more common problem - influenza. Up to 20% of Americans develop influenza during each flu season, which generally begins in November, with 200,000 people on average requiring hospitalization and 20,000 dying from the disease or its complications. The good news: there is a safe and effective vaccine that is readily available. The bad news: only 60% of those likely to need hospitalization or die because of influenza have been vaccinated in past years. These people should have gotten vaccinated during October, but it's not too late.

Everyone over 65 years old, anyone with a chronic medical condition (heart or lung disease, including asthma, diabetes, kidney or liver disease, chronic malignant diseases or anemia) or those with a suppressed immune system, needs a flu shot now, as do children who must take aspirin long-term, women who will be in the second or third trimester of pregnancy during the flu season, and health-care personnel who minister to high-risk individuals. Others advised to get the flu shot during November include healthy people between 50 and 65, household members who live with anyone over 65 or with chronic diseases, and anyone else who would like to avoid the flu.