Smallpox Standoff

Article excerpt


President Bush's plan to protect Americans against a terrorist attack through a phased-in mass vaccination has come to a virtual standstill due to unexpectedly stiff resistance from health care workers. We had hoped that such smallpox refusniks numbered only a small fraction of the national total, and thus posed merely a minor threat to public health preparedness. Unfortunately, that is not the case.

According to recent reports, about 4,200 individuals have been vaccinated - less than 1 percent of the administration's target for this first phase and about 495,000 short of where the administration hoped to be at this point, a month after the campaign began. Several factors appear to be responsible for this standoff. Some health care unions have advised their members not to take the vaccine until the federal government commits significantly to a compensation fund. Some health professionals are reluctant to place themselves or their patients at risk from adverse effects of an inoculation in the absence of an imminent threat. Also, senior administration officials have not pushed smallpox vaccinations with the requisite urgency. When they have done so, it has seemingly been with the wrong sense of proportionality - placing too much emphasis on the small risk of adverse effects from inoculation, and too little emphasis on the catastrophic effects of a smallpox attack on an unvaccinated population.

Those risks have been well-documented, but they are worth repeating. Historically speaking, the smallpox virus has killed one of every three unvaccinated individuals it infected. Those who survived were often horribly scarred, and quick inoculation remains the only proven way to prevent such effects.

In the event of a smallpox attack, those infected would have only a three-day window in which to be vaccinated against the virus without adverse effects. That is, individuals showing the initial flu-like symptoms of a smallpox infection (if they show any symptoms at all) will have merely 72 hours during the panic, confusion and travel restrictions of a smallpox attack in which to find a doctor able to make the proper diagnosis and correctly apply the smallpox vaccine. …