Last Updated

08 Jan 2003

Source: Wall Street Journal, July 8, 2002.

REVIEW & OUTLOOK

Small Thinking on Smallpox

U.S. officials have begun to broadcast that they will deign to immunize 500,000 Americans against smallpox , as a precaution against more bioterrorism. Thank goodness for small favors, but what about the rest of us?

The plan, now leaking out to the press, is to immunize nurses, doctors and other health workers as "first-responders." The thinking goes that they would descend on the area of an attack and provide for treatment and mass vaccination after the fact. The plan follows with some modifications the advice recently presented by a committee of public-health experts, who in their wisdom deemed it unnecessary to immunize all Americans in advance.

Pardon us, but isn't that something Americans should be able to decide for themselves? The officials now telling us that they can handle any smallpox outbreak are the same folks who took weeks to figure out what was happening during last year's anthrax attacks. Granted the threat caught everyone by surprise last year. But smallpox is both more lethal and more contagious, so thousands could be infected by the time the public-health priesthood figured out who was on first.

There are risks to mass immunization, but presumably Americans who chose to be vaccinated would go in with that knowledge. They could even sign a waiver absolving the government of liability. Those most vulnerable to complications -- mainly the immune deficient -- are also better screened at a careful pace in advance than in a panic amid an attack. And the old excuse that there isn't enough smallpox vaccine doesn't hold anymore, with 100 million doses already available and the government stockpiling more all the time.

The Bush Administration needs to assert some leadership over a public-health bureaucracy that doesn't appear to trust average Americans. Why should the government deny preventive medicine to citizens who voluntarily seek it?