Little has changed since they quit giving smallpox vaccinations to American children more than three decades ago.

They still have the same kind of medically prehistoric two-pronged needle for repeatedly poking the skin and applying a tiny drop of the gooey vaccine.

They're still drawing from the same lot of vaccine concocted in the early 1970s, simply because there's been little demand for a new batch. And like so many other things in the '70s -- most notably Folger's instant coffee -- it was freeze-dried. Just add the appropriate solution.

The government eliminated vaccinations for American children in the early 1970s, and the last known case in the world surfaced in Somalia in 1977.

What's changed is that smallpox is again considered a threat in North America even though there hasn't been a known case of the disease on the continent since the late 1940s.

That is why about 25 hospital workers learned the basics of giving vaccinations Monday during a seminar at the Stanislaus County Health Services Agency.

Smallpox is a virus spread from person to person through the air. Before vaccinations, the virus killed hundreds of millions of people. Millions more were scarred or blinded before research led to an effective vaccine.

Terrorist threats have forced health officials to be ready to fight again the first disease ever conquered by humans.

Representatives from the county's five acute care hospitals -- Modesto's Doctors Medical Center, Memorial Medical Center and Stanislaus Surgical Hospital, Turlock's Emanuel Medical Center and Oakdale's Oak Valley Hospital -- attended the seminar Monday, along with county health professionals.

Those workers will be among about 150 volunteer first responders -- those who will deal with patients in emergencies -- who will be vaccinated beginning March 21.

The vaccine is being offered to emergency room workers across the nation now. In a second stage, it is supposed to be offered to millions more health care workers, along with emergency responders, although it's unclear when those inoculations will begin.

3.5 million health care workers to be informed

The national Centers for Disease Control and Prevention also is sending mailers to 3.5 million health care professionals. The information is meant to help doctors, nurses and other clinicians recognize a case of smallpox, should the disease appear.

Some health workers will be revaccinated for the first time since they were children. But one -- county infectious disease control officer Karl Olson -- is a veteran at this.

"I was vaccinated when I was 7," he said. "I had it done again in the Army."

And he'll have a third vaccination later this month, since all health services workers who vaccinate and treat patients must update their immunities.

"There's no real evidence there is any long-term effect," he said. "You have to get it again."

Unlike some other vaccines, the smallpox serum doesn't include antibodies from the actual virus it wants to kill. Instead, it is derived from the so-called cowpox virus, said John Walker, public health officer for the Health Services Agency.

Pat Kirby of the state's Department of Health Services took the volunteers through the procedure, including practice pokes -- teaching the proper way to administer the vaccine with the two-pronged needle.

Kirby taught them to distinguish between normal and adverse reactions -- and what to do in case of the latter.

And she taught them the proper methods of vaccination, including the way to bandage the area afterward.

"I don't remember Mom taking any precautions like this," said Jan Husman, a public health worker at the Health Services Agency.

She volunteered as a first responder because she could. "I don't have any small children at home," she said. "My husband doesn't have any health issues."

Ginger Merrill, of the Community Services Agency, agreed.

"We're a little low risk," she said.

Phyllis Sarasqueta, who works for the county's adult protective services, said it makes sense to get vaccinated and be ready in case the virus becomes a problem.

"You know you're doing something that will be beneficial," she said. "We are disaster workers. We need to be ready."

The Associated Press contributed to this report.

Bee staff writer Jeff Jardine can be reached at 578-2383 or jjardine@modbee.com.

Reprinted by permission of Modesto Bee.