AMERICA has ruled out vaccinating most of its citizens against smallpox. Only the 20,000 or so staff who would have to deal with an outbreak should get the vaccine, say experts who last week reviewed US plans for handling a smallpox attack.
鈥淩ight now, the assessment is that the smallpox risk is very low,鈥� says Julie Gerberding, acting deputy of the Centers for Disease Control in Atlanta, Georgia. People have a greater risk of a bad reaction to the vaccine than catching smallpox in a bioterrorist attack, she says.
Experts on the CDC鈥檚 Advisory Committee for Immunization Practices recommend a 鈥渟oftly-softly鈥� approach which would mean vaccinating nurses and the other emergency workers first on the scene of a suspected outbreak. Also vaccinated should be specialist staff at hospitals designated to handle cases in each state. Otherwise, the committee experts urge the CDC to stick to its original plan to contain and confine any outbreaks through 鈥渞ing vaccination鈥�.
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But some experts believe this strategy is doomed to fail because the virus would outrun the containment measures. 鈥淯ntil the CDC adopts an effective post-attack strategy, the country remains at high risk of preventable death and suffering,鈥� says Bill Bicknell of Boston University. He says far more people should be vaccinated because people who don鈥檛 know they are infected could turn up at any hospital or surgery. 鈥淚t would be far more sensible to vaccinate the entire staff of all hospitals and primary care sites, including private pharmacies.鈥�