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Last Updated

16 May 2003

Source: Newsday, May 16, 2003


Scale Back National Effort to Vaccinate for Smallpox

The Bush administration's ambitious plan to vaccinate hundreds of thousands of health care workers and later several million emergency response personnel against smallpox has fallen flat. President George W. Bush must approve a less sweeping alternative that would still provide an adequate - but much smaller - number of vaccinated health care workers in case of a bioterror attack.

Five months after Bush was inoculated to kick off his national smallpox preparedness campaign, only about 35,000 of the targeted 500,000 health care workers have been vaccinated, and the federal Centers for Disease Control conceded that a national target of 50,000 would be far more realistic. Many doctors and nurses have resisted the vaccine because of severe possible side effects and its worrisome link to several cases of heart inflammation.

The original goal seemed sensible in light of the bioterror threat posed by Saddam Hussein and terror networks to which he may have transferred his bioweapons. This newspaper endorsed the vaccination plan for health and emergency personnel, though it cautioned that inoculations should be voluntary for the general public. However, it is now clear that the vaccination campaign must shift gears.

Since the end of the Iraqi war, public fears about a bioterror attack have lessened considerably. Whether this perception is valid or not, it has increased reluctance among health care workers to accept the vaccine. Bush should accept the CDC advice to reduce the goal to 50,000.

Victims exposed to smallpox can still take the vaccine up to four days after exposure and be protected. But that sense of safety could be illusory if a person doesn't know exactly when the exposure occurred. And health authorities also fear that if nurses and doctors wait to be inoculated until after an attack, minor reactions to the vaccine could sideline them crucial days when they would be needed for the emergency.

As SARS has shown, prompt medical response is crucial to stop an epidemic. The administration must ensure adequate coverage for smallpox or the nation will be caught short in an attack. Ultimately, an irreducible level of risk must be accepted by a minimum number of health care workers. But vaccination ought to be voluntary as much as possible.