Smallpox vaccine for all Americans

AN effective but risky smallpox vaccine is to be made available to every person in the United States, beginning with the military and health workers who would be in the front line of any bioterror attack.

President George W Bush will announce the plans today and courses of injections could begin as soon as January, senior administration officials said.

The shots will be compulsory for about 500,000 military personnel and will be recommended for another half-a-million who work in hospital emergency rooms and on special smallpox response teams.

The general public will be offered the vaccine on a voluntary basis as soon as large stockpiles are licensed, probably early in 2004, though the government will not be encouraging people to get them.

In taking the decision, Mr Bush had to weigh the risks of the often-deadly disease against the dangers of the vaccine, which produces more serious side effects than any other vaccine dispensed in the United States.

In his limited public comments on the matter, Mr Bush has emphasised his concerns about the vaccine, and he said on Wednesday that people will have to consider its dangers.

“It is going to be very important for us to make sure there’s ample information for people to make a wise decision,” Mr Bush said.

Federal health officials are preparing a massive public education campaign about both the disease and the vaccine. Recent polls show most people would choose to have the vaccine if given the chance, but health officials fear many do not adequately understand the risks.

Based on studies from the 1960s, about 15 out of every one million people vaccinated for the first time will face life-threatening complications, and one or two will die. Reactions are less common for those being revaccinated.

“The success of a vaccination programme is going to depend on our success in communicating with people accurately and openly,” said Dr Julie Gerberding, director of the Centres for Disease Control and Prevention.

Smallpox, once among the most feared diseases, killed hundreds of millions of people in past centuries, but it has not been seen in the US since 1949 and was declared eradicated worldwide in 1980. However, experts fear it could be used by hostile nations or terrorist groups in an attack. Intelligence experts believe four nations, including Iraq, have unauthorised stocks of the virus.

Vaccinating people against the disease makes enemies less likely to use it, said Senator Bill Frist of Tennessee, who is also a doctor and has been encouraging Mr Bush to offer the vaccine widely: “It is the right step to protect the American people and it is the right step to make our nation less vulnerable to those who would use smallpox to terrorise our citizens. This is a difficult decision, but it is the right decision.” Mr Bush’s vaccination plan represents a remarkable journey of public policy. Just this summer, federal health advisers were recommending a much more conservative vaccination programme, perhaps 15,000 to 20,000 people in total.

If smallpox appeared again, it was reasoned, people could be vaccinated in an emergency campaign. The vaccine is effective if delivered a few days after being exposed to the disease.

Despite concerns, the administration’s vaccination plan scaled up quickly as the government bought enough vaccine to cover everyone as the nation moved closer to war with Iraq.