Due to new concerns over smallpox vaccinations possibly being linked to heart disease, the Alabama Depart-ment of Public Health (ADPH) has temporarily discontinued administering smallpox immunizations until educational materials can be updated for prospective recipients of the vaccine.

New information includes the risk factor of heart disease as a contraindication for immunization and the Centers of Disease Control and Pre-vention (CDC) has asked those diagnosed with heart disease not to be vaccinated against smallpox until it can be determined whether there is a causal link.

Winkler Sims of the ADPH said Wednesday that the discontinuation was requested following new information released by CDC and also in the aftermath of three people dying following the smallpox immunization.

"We have gotten some updated forms for people (to be vaccinated) can fill out and once we received the updated information from certain people we should be able to proceed as normal with the vaccinations," said Sims.

Sims said the ADPH has almost completed its initial phase of the smallpox vaccinations,

which involved facilities such as hospitals, and has just a few small groups left with that phase before the next phase, involving local health departments and hospital health care teams.

A total of 425 persons in Alabama received smallpox vaccinations between Feb. 18 and March 24 at health department clinic sites and hospitals, including hospitals in Andalusia and Opp. Some 27 hospitals have participated in the effort overall.

According to a release from the CDC, the agency is investigating whether there is any association between smallpox vaccination and reports of heart problems in seven health care workers who have been vaccinated.

The CDC is recommending that persons with known cardiac disease, such as cardiomyopathy, previous heart attack, history of angina, or other evidence of coronary artery disease, be temporarily deferred from receiving smallpox vaccination. CDC will provide states with simple questions about heart problems to use in screening people volunteering for smallpox vaccination.

In attempting to follow the safest standards possible, last week the CDC asked the Advisory Committee on Immunization Practices (ACIP) Smallpox Vaccine Safety Review Board to examine reports of heart-related adverse events occurring in connection with the smallpox vaccination program.

The CDC is also beginning research projects aimed at identifying and understanding any associations that may exist between smallpox vaccine and heart-related problems.

The agency has, according to its press release, received several reports of heart-related problems among the 25,645 people who have been vaccinated in the civilian program.

Cases of heart inflammation following smallpox vaccination were reported in the 1960s and 1970s. However, the information from these reports does not provide any information about the types of people who may be at higher risk for heart-related problems following smallpox vaccination.