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Addressing the Smallpox Threat

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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.

Return to Audioconference


The information on this page is archived and provided for reference purposes only.


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