Topeka ? Health care workers rolled up their sleeves Friday for the first phase of the state’s plan to protect against a bioterrorism attack involving smallpox.

The process began at the top, with state epidemiologist Dr. Gianfranco Pezzino taking the first vaccination. In all, 11 Kansas Department of Health and Environment staff were vaccinated, with two others deferring vaccination because of temporary medical conditions.

“It’s done,” Pezzino proclaimed, as dozens of reporters, cameras and KDHE staff observed.

The workers vaccinated Friday will be monitored for side effects over the next two weeks. KDHE staff who become ill will have to take sick leave or use their own vacation days, Pezzino said.

Nationwide, some health care workers have declined to take the voluntary vaccinations over concerns about compensation if complications occur. Some Kansas hospitals, including the Kansas University Medical Center, have declined to participate in the initial vaccinations.

Pezzino, director of the state’s bureau of epidemiology and disease prevention, said Kansas did not have an official policy for addressing compensation issues.

“These are situations that rely on federal solutions, not state solutions,” Pezzino said.

Kansas has received 3,000 doses of vaccine. Kits are in groups of 100, and take up the space of a videocassette.

Training will continue for the next two weeks before clinics open in Garden City, Great Bend, Kansas City, McPherson, Overland Park, Parsons, Topeka and Wichita. As was the case in Topeka, National Guard military police will provide security for the vaccine and each clinic.

A second phase will involve vaccinating first responders, such as police, fire and emergency medical personnel. The general public will be vaccinated in the third phase.

Amy Biel, a KDHE staff member trained in epidemiology and data analysis, deferred her vaccination because she is having her tonsils removed. Biel would be part of the KDHE’s rapid response unit that would go to the site of any smallpox outbreak.

Amy Biel, a member of the Kansas Department of Health and Environment smallpox response team, left, receives a saline injection, meant to serve as practice for an actual smallpox inoculation during a mock clinic in Topeka. Deanna McClenahan, a nurse consultant, gave the shot Friday while the department's immunization director, Sue Bowden, watched. Several department members on Friday received smallpox inoculations, the first of their kind for civilians in Kansas since the early 1970s.

Biel, 34, who was vaccinated as a child, went through Friday’s mock vaccination clinic, staged for the media. Biel received a saline vaccination, simulating the smallpox vaccine.

She also will help at the clinics when the first vaccinations are given.

“This is just another hazard of the job,” she said. “Most of us are in public health because we want to be.”

Pezzino was vaccinated in Italy at age 13 and remembers that residents were not concerned then because smallpox still existed in world populations.

“If the risk is there, people don’t question it too much,” he said. “It was like any shot.”

The Kansas plan was approved by the Centers for Disease Control and Prevention in Atlanta, following federal guidelines. Each state was required to submit a plan, though procedures differ in each state.

Pezzino said the threat of smallpox, based on its history of harming large populations, should not be ignored, even if no outbreaks have occurred in 20 years.

“You don’t know what the exact risk is,” Pezzino said. “We know it’s low, but not zero.”