Experts wary as smallpox vaccine plan advances

[Guest guest]

Steve Sternberg USA TODAY

President Bush (news - web sites)'s plan to resurrect smallpox vaccination

for millions of Americans provoked criticism Monday from experts who say the

plan is too sweeping, will cause needless illness and will soak up resources

that could be better used to meet other public health needs.

The administration fears that bioterrorists, Iraq or other rogue countries

may unleash the virus, which kills 30% of its victims, against the United

States. To prepare, the Bush administration proposed on Friday a program to

vaccinate 510,000 troops, 500,000 health workers and up to 10 million first

responders, including police, firefighters and emergency medical

technicians. These volunteers would lead the effort against a smallpox

attack.

In an interview Monday with USA TODAY's editorial board, Secretary of Health

and Human Services (news - web sites) Tommy said plans for the

first wave of vaccinations have been submitted by every state but Colorado,

which is racing to complete its plan. The states have identified 440,000

health workers for voluntary vaccination.

said about 5 million of a possible 10 million first responders will

probably be vaccinated in a second wave. The vaccination program will begin

in late January and end four months later. After that, he said, other

Americans who want vaccinations will be able to obtain them. The

administration recommends against vaccination for members of the public.

But even health experts who favor preparedness say the benefits of

vaccination are hard to calculate because the risks of an attack are

unknown. ''What's my chance of getting a disease that only exists in a

test-tube somewhere around the world? I have to call the CIA (news - web

sites) and ask them,'' said Craig , an infectious disease specialist at

Phoebe Putney Memorial Hospital in Albany, Ga.

Atlas of the American Society of Microbiology called the president's

plan to inoculate troops who might serve in Iraq ''a wise decision.''

But he questioned whether Americans would be willing to accept the risk of

widespread use of a vaccine that causes severe side effects in one of every

20,000 recipients and kills one or two per million.

''When you have parents saying, 'I want my children vaccinated now,' '' he

said, ''you know they haven't come to grips with the risk, or they've become

caught up in the rhetoric of a war with Iraq or fear of a bioterrorist

attack.''

Before smallpox vaccinations ended in 1972, Atlas said, as many as 10

children died each year from side effects of the vaccine, which was accepted

because the death toll from the smallpox virus was far greater.

''I certainly do not concur with the notion that the general public ought to

have access to the vaccine at this time,'' said Schaffner of

Vanderbilt University.

Assistant Secretary of Defense Bill Winkenwerder said that there were no

deaths among thousands of soldiers vaccinated between 1945 and 1990, but he

concedes soldiers are a healthy population.

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