Public-health divisions across the country are being forced to decide which standard programs and services, such as child vaccinations and tuberculosis prevention, can be neglected in order to deal with the lengthy process of vaccinating public-health employees for smallpox. However, Madison City Health Administrator Katherine Vedder said the strain on Madison’s public-health system has not been serious … yet.

“The state gave us the vaccines to use,” Vedder said. “But we had to use our own time and resources. It wasn’t that difficult, but any more would have been a struggle.”

Sixteen city health employees have been vaccinated since President Bush’s order of the voluntary vaccinations last December.

“We had many volunteers, but I only allowed 16 to be vaccinated,” said Vedder, who has received the vaccination herself. “We only allowed people free of risk to receive the vaccination.”

Anyone with heart problems, weak immune systems, past skin disorders or small children at home was not allowed to receive the vaccination.

According to the Center for Disease Control, one in 1,000 people who receive the vaccination may face serious side effects.

At the county level, response from public-health employees has been less enthusiastic. Only two nurses received the vaccination, said Dane County Public Health Administrator Gary Johnson.

“Where we are, we don’t see any clear and present threat,” Johnson said. “No one is blowing it off; it’s just difficult to take time for it when we are busy dealing with real issues.”

Johnson said one main reason for the lack of volunteers is that no measures are in place to protect those who come in close contact with individuals who receive the vaccine.

Although those vaccinated can pass the virus through a scab that forms after the vaccine is administered, current legislation only provides for those who are actually vaccinated and not those who contract the disease from a vaccinated person. However, Congress is examining a bill that would include protection for those who contract the disease in this way.

“If the bill passes, I think a lot of people would reconsider the vaccination,” Johnson said.

Currently, preparation for bioterrorism is in Phase I, which includes the voluntary vaccination of emergency-rescue workers such as paramedics and first responders. There would also be a call for more public-health workers to receive the vaccination.

“If we ever get there, the strain on the public-health system would be great,” Johnson said. “The nation’s public-health system has been underfunded for decades. The bioterrorism scare has forced this issue to everyone’s attention.”

Johnson said if more funding were to be allocated for smallpox vaccinations, funding for programs such as Women Infants and Children, home visiting for parenting support and other immunizations would be significantly reduced.