Providers prepare for worst

INDIANAPOLIS -- Public health workers in Indiana began receiving smallpox vaccinations Tuesday as part of a national effort to create a core group immune to the disease if it ever is used by terrorists.\nSeveral health care workers, including both doctors and nurses, were vaccinated Tuesday in Indianapolis in the first phase of the project started by President Bush in December.\n"The purpose of these teams is to provide care in the event of an emergency," said Robert Teclaw, Indiana's state epidemiologist and one of those overseeing the vaccinations. "This event is to vaccinate the vaccinators."\nRoutine vaccinations for smallpox, a disease with at least a 30 percent fatality rate that causes blisters and a high fever, ended in the United States in 1972. The last U.S. case of the disease was reported in 1949.\nClinics in 10 districts throughout the state will soon begin vaccinating health care workers who volunteer for the vaccination.\nOver the next 1 to 1 1/2 months, volunteers will be vaccinated in Valparaiso, South Bend, Lafayette, Terre Haute, Evansville, Fort Wayne, Muncie, Indianapolis, Jeffersonville and Bedford.\nThe actual vaccination, which involves three to 15 relatively painless pricks with a two-pronged needle, injects a drop of vaccine directly under the skin. The process can leave a distinctive, dime-sized red scar on the arm.\nExperts estimate that between 15 and 43 out of every million people being vaccinated for the first time will face serious complications.\nState health officials say nothing is routine about reintroducing the vaccination.\n"We have some frightening things going on in the world," said Margaret Joseph, a spokeswoman for the Indiana Department of Health. "What we are doing is good public health."\nSmallpox vaccinations have already started for health workers in 18 other states, but federal officials do not yet plan vaccinations for the general public.\nThe government plans to screen health care workers and first responders for conditions such as weak immune systems or skin conditions that could complicate the vaccination.\n"We take these risk everyday in our care of patients," said Dr. Joe Francis, an intern at St. Vincent Hospital in Indianapolis and one of those vaccinated Tuesday. "It's important to get a small group of core workers up front to prime the pump"