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Last Updated

12 Aug 2003

Source: Reuters, August 12, 2003

No Need for General U.S. Smallpox Shots - Report

By Maggie Fox, Health and Science Correspondent

WASHINGTON (Reuters) - Members of the general public should not get the smallpox vaccine now being given to soldiers and front-line health emergency workers in case of a biological attack, experts said on Tuesday.

Noting that the vaccine is dangerous and the risk of a smallpox attack is only theoretical, the Institute of Medicine committee said it does not really matter how many people are vaccinated, as long as the right preparations are in place.

"Smallpox is not the only threat to the public health and vaccination is not the only tool for smallpox preparation," Dr. Brian Strom, Professor of Medicine and at the University of Pennsylvania School of Medicine and chair of the committee, told a telephone news briefing. The Institute, an independent organization that advises the federal government on health matters, praised The U.S. Centers for Disease Control and Prevention for its six-month-old vaccination effort.

But it said people and especially the media were confused about how many health workers should be vaccinated under the program, aimed at preparing the United States in the event that smallpox was used as a biological weapon.

It noted the many media reports about the reluctance of health workers to get vaccinations, in part because of concerns about compensation in case the vaccine makes them ill and in part because of safety fears.

CDC director Dr. Julie Gerberding has said repeatedly the effort is not about numbers but about overall preparation, and Strom agreed. "What happens if there is an attack? Do (vaccinated) people have beepers?" he asked.

"It's important to realize that vaccine numbers are not low."

The committee also worried that the vaccine efforts might divert resources from other public health responsibilities such as childhood vaccination.

It recommended setting up a registry of vaccinated people, in case they move on to other jobs or places, so they could be contacted to help in case of attack. The CDC should also write up possible attack scenarios so hospitals and communities can practice to be ready for them, it said.


Smallpox was eradicated in 1979 but the U.S. government and a range of experts believe some governments and groups may have developed the virus for use as a biological weapon.

So the government launched a plan to vaccinate up to 500,000 U.S. troops and an equal number of health and emergency workers to make up the front-line response in case of attack. Eventually, the plan called for as many as 10 million people to get the immunization.

So far, about 38,000 civilian health care workers and more than 450,000 military personnel have been vaccinated.

Surveys have suggested that as much as 60 percent of the general public would also like to get the vaccine, and President Bush has instructed the CDC to come up with a plan for doing so.

"At the current time the general public cannot get the vaccine," Strom said.

The vaccine uses a live virus related to smallpox called vaccinia. When widely used it killed one to two out of every million people who received it and caused serious side-effects, ranging from a serious rash to a swelling of the brain called encephalitis, in dozens more.

Virus from the vaccination site can spread to other people, perhaps causing disease in those with damaged immune systems -- such as cancer and AIDS patients.

"When you take a vaccine or a drug for yourself, you are making a decision that 'I am willing to take the risk'," Strom said.

"The problem in this case is the smallpox vaccine is a live virus vaccine. In taking on that risk you are taking it not only on yourself, but on the people around you," he added.