More of the same here too..
Smallpox vaccine risk hits home for Minnetonka doctor
Maura Lerner
Star Tribune
Published 03/29/2003
Dr. Cynthia Olson of Minnetonka considers herself lucky. One day she was getting her smallpox vaccine, and two days later she was making medical history.
Olson, 45, a dermatologist at Hennepin County Medical Center, is one of seven U.S. health workers who suffered heart problems after getting the vaccine, prompting a nationwide alert this week.
As of Friday, three people who received the vaccine have died of heart attacks in the past week.
Two of them, a Maryland nurse and a Florida health worker, died of heart attacks, earlier this week. And the Pentagon reported Friday that a 55-year-old National Guardsman had died this week after suffering a heart attack.
Olson said her illness was "a bolt out of the blue." She was hospitalized in early March with myocarditis, an inflammation of the heart, and has largely recovered.
"I don't think this was a predictable thing, in my case for sure," she said Thursday.
Her case illustrates the emerging uncertainties around the smallpox vaccine, which may carry greater risk than experts realized. At the same time, they can't be sure these heart problems didn't have other causes.
Federal officials on Tuesday warned for the first time that people with heart disease should not get the smallpox vaccine until further investigation. Both of the health workers who died and the Guardsmen had risk factors for heart disease. On Friday, a federal advisory committee said it was considering excluding anyone older than age 50 from the vaccine program.
But Olson says even those warnings probably wouldn't have helped her. "I have a couple of of risk factors, but otherwise nothing that would tell you I had heart disease," she said.
The U.S. Centers for Disease Control and Prevention (CDC) issued the warning after spotting an alarming trend: seven cases of sudden heart problems, including Olson's, among the 25,645 health workers who had been vaccinated between January and March 21. Another 10 military cases were reported this week.
Until now, experts said the vaccine carried a one in a million chance of causing death, primarily from bloodstream infections. But that estimate didn't take into account the possible link to heart disease.
Olson, who decided to tell her story publicly, says she has little doubt the vaccine was to blame.
She received the vaccine on Wednesday, Feb. 26, two weeks after Minnesota started its vaccine program for health workers.
Two days later, she said, she felt an ache in her shoulder as she lay on the couch, watching television. "Then I noticed that my chest hurt," she recalled. "I took some Alleve and went to bed." Over the weekend, she had chest pain and shortness of breath. But she ignored the symptoms for days until, back at work on Monday, she found herself gasping for breath.
"I probably should have gone to the emergency room," she says now with a rueful laugh. Instead, she finished her shift and went home. The next day she was hospitalized, and doctors discovered that her heart muscle was inflamed and malfunctioning.
After two days in the hospital, she was well enough to return home.
And she says her recovery has been steady and "relatively rapid."
"I won't go as far as to say I'm completely back to normal," she said Thursday. But she expects a full recovery.
The Minnesota Health Department says her illness could have been triggered by the flu, which also can cause myocarditis. However, it notified federal officials, as required, and lists her case as one of five "possible/confirmed smallpox vaccine reactions" among the 1,439 recipients in Minnesota. The other four involved minor rashes.
Olson dismisses the flu theory.
And she applauds the CDC for issuing this week's warning. "I think that that was prudent," she said. Her case was included, anonymously, in a CDC report issued Friday, entitled "Cardiac Adverse Events Following Smallpox Vaccination."
Four of the seven had a history of heart disease.
The report concludes that, "as a precautionary measure," people with a history of heart disease or specific symptoms be excluded from the vaccine program.
But Olson said that probably wouldn't have helped her because her only known risk factor is high blood pressure, which is controlled with medications.
"I think maybe that they should concentrate on younger individuals," she said of the vaccine program. "That would make some sense in minimizing the risk. . . . If I were to advise them, that's what I'd say." |
