CAPT Richard Caldwell, a physician in the U.S. Public Health Service Commissioned Corps, is an experienced medical officer who is the sole health care provider for the Havasupai American Indian community in Arizona. His dedication to his job ensures that he is always available to provide calm, confident, and experienced medical care to a community that is underserved and lives in a very remote location. CAPT Caldwell also works with wilderness rescue in the Grand Canyon to respond to emergencies involving visitors to the National Park. “Serving as the sole medical officer for the community is demanding, but it is also extremely rewarding,” says CAPT Caldwell. 

As a medical toxicologist at the Centers for Disease Control and Prevention, LCDR Joshua Schier is part of a team responsible for protecting the country’s health from terrorist acts involving chemical agents. LCDR Schier and his team constantly monitor and analyze the data for many chemical-based public health threats. LCDR Schier is a trained physician and is board-certified in both emergency medicine and medical toxicology. “Service to the Corps is a demonstration of a commitment to a higher purpose, beyond simply doing one’s job,” says LCDR Schier.

LCDR Jamal Gwathney cares for patients with some of the poorest health statistics in our Nation’s capital. “That is where the Commissioned Corps puts you: where the need is greatest,” he says. In his current assignment through the Health Resources and Services Administration, LCDR Gwathney serves as associate medical director at East of the River Health Center, a Unity Health Care facility, located in Washington, DC’s Ward 7. As a family medicine physician, he provides cradle-to-grave care for his mostly African-American patients. In addition, LCDR Gwathney is a member of the Commissioned Corps’ elite Ready Responders program. Approximately 70 to 80 commissioned officers are trained specifically to decontaminate and treat individuals and communities in the event of any type of natural or human-made disaster. Being involved in all of these aspects of public health makes LCDR Gwathney proud to be an officer in the Commissioned Corps.

While many health care professionals have traditional careers, an elite number of health experts like these officers use their health care training to treat community members in need, respond to disasters, and help protect the Nation’s food supply.

The U.S. Public Health Service Commissioned Corps is a team of more than 6,000 well-trained, highly qualified public health professionals. They work to promote and protect the Nation’s health and safety by responding to large-scale health disasters and emergencies wherever and whenever they strike.

The Commissioned Corps recently launched a recruitment effort that will hire hundreds of doctors, nurses, dentists, pharmacists, and other health care professionals from across the country. Here’s a closer look at what a career in the Corps entails:

Making a Difference
Commissioned Corps officers provide health care to underserved communities; help prevent the spread of disease; and even help ensure that the Nation’s food supply, drinking water, drugs, medical devices, and environments are safe. Other assignments include:
• Conducting and supporting cutting-edge research for the prevention; treatment; and elimination of diseases, health disparities, and injuries.
• Working with other nations and international agencies to address global health challenges.

Rushing Relief
As 1 of the 7 Uniformed Services of the United States, more than 2,400 members of the Commissioned Corps were deployed to the Gulf Region before, during, and after Hurricanes Katrina and Rita. Corps members set up and staffed field hospitals and emergency medical clinics, treated sick and injured evacuees, conducted disease surveillance, and worked closely with local and State health authorities to plan for long-term public health needs.

Benefits
Commissioned Corps officers receive competitive compensation, including health and dental care at no cost, tax-free housing, 30 days of paid vacation a year, malpractice insurance coverage, and a host of other benefits.

“Serving our country is a noble calling,” says Acting Surgeon General Steven K. Galson, M.D., M.P.H. “Our officers prevent and treat disease, ensure the safety of food and medicine, and restore health and hope in times of greatest need. Right now we’re increasing the number of Commissioned Corps officers and restructuring the deployment process to meet those needs even better.”

For more information, visit www.usphs.gov.

Students enrolled in a full-time health or health-related undergraduate or graduate course of study are invited to submit a poster presentation for the 2008 U.S. Public Health Service Scientific and Training Symposium. The conference will be held June 9-12 at the Tucson Convention Center. More than 1,000 public health administrators, providers, clinicians, professors and representatives from business employing public health professionals are expected to attend. This is an excellent opportunity to obtain experience presenting and to network with others in the field.

Posters can be on any topic related to the field of public health. They will be viewed by attendees from 12 to 5pm at the Tucson Convention Center on Monday June 9 and will be on display during the opening reception from 6 to 8 pm that evening. Students will be asked to stand with their poster to answer questions during these times. The dimensions for each poster are 8′ x 4′ and the deadline for submissions is May 23. Submissions will be reviewed on an ongoing basis and those who submit proposals will be notified of the result weekly (wherever possible). All selected presenters will be notified by May 30. Visit http://www.phscofevents.org/agenda/StudentPoster.cfm to submit.

Students are also encouraged to attend the conference. Registration is free for full-time students (excluding meals). Take advantage of this unique opportunity to learn more about public health and the opportunities in this growing and important field! Visit www.phscofevents.org and sign up today!

Benefits and Risks of Immunization
Over ten million childhood vaccinations are given to children (birth through 5 years) annually, and many millions of doses are given to adults.  All medicinal products, including vaccines, have risks and benefits.  Vaccines protect many people from dangerous illnesses, but, like drugs, can cause side effects, a small percentage of which may be serious.  The benefit of vaccines is measured as prevented disease, and the risk of vaccination is measured as potential side effects; both are monitored as part of the US public health system. 

Pre-Licensure Evaluation of Vaccines
Licensure requires extensive clinical evaluation of the vaccine’s safety and effectiveness which is completed in stages over several years.  First, laboratory and animal studies are performed. Then candidate vaccines are tested in small groups of adult volunteers to establish first the safety, and then, the efficacy of the vaccine.  Finally larger-scale clinical trials, usually randomized and placebo-controlled, measure the rates of the more common adverse events and the protective efficacy of the vaccine.  The control groups in these clinical trials who do not receive vaccine are critical to distinguishing between vaccine-related events and an event unrelated to vaccine but occurring spontaneously in the study population.  Rates of the most common vaccine reactions, such as injection site reactions and fever, can be estimated before licensure, but the comparatively small number of patients enrolled in these trials  generally limits detection of rare events or events that occur after long-term exposure.  Even the largest pre-licensure trials (>10,000 persons) are inadequate to assess the vaccine’s potential to induce rare but serious side effects.  Consequently, it is essential to continue to collect information on vaccine-associated adverse events after licensure which may only occur after wide-scale use of the vaccine in the general population.

Post-Marketing Surveillance
Post-marketing surveillance is a necessary component of vaccine safety monitoring.  The manufacturers’ label/product information approved at licensure has the potential to be continuously updated as significant adverse event information which differs from what was originally known at the time of approval is compiled.  Due to the relatively small number of patients studied in pre-licensure studies, rarer side effects or events that may only occur in a sub-group of the population not significantly represented in pre-marketing studies (e.g., neonates and infants who receive hepatitis B vaccine, pregnant women, immunosuppressed patients), or side effects that occur only with chronic or
repeated exposure to a vaccine-induced antigen may not be revealed until the vaccine is licensed to the general public.

The objectives of post-marketing surveillance are to identify rare adverse reactions not detected during pre-licensure studies, monitor increases in known reactions, identify risk factors or pre-existing conditions that may promote reactions, and identify particular vaccine lots with unusually high rates or types of events.

Adapted from: Post-marketing surveillance for adverse events after vaccination: the national Vaccine Adverse Event Reporting System (VAERS), U.S. Food & Drug Administration.