Smallpox Vaccinations -
Americans Face A Deadly Choice
By Wes Vernon

WASHINGTON - Americans may face two choices in deciding whether to be vaccinated for smallpox: the risk of death if they don't take pre-emptive action or the risk of death (albeit less likely) if they do.
Sen. Arlen Specter, R-Pa., says he would not hesitate to have his four grandchildren vaccinated for smallpox.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told the senator at a recent hearing that he personally would vaccinate his children, as well. However, he says there needs to be an "open discussion" of the trade-offs in administering massive vaccinations until or unless the disease has actually struck.
Specter is impatient with scientific concerns about the risks involved in pre-emptive vaccines. He says let the parents or grandparents make that decision.
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The odds are these. If there were a massive nation-wide vaccination program, estimates are that at least 300 to 600 Americans would die, or 1 to 2 out of every million. And that is a conservative projection. This does not include the risk of side effects short of death, although these too are believed to be minimal. The elderly, babies under 1 year old, and pregnant women are believed to be especially vulnerable.
That sounds like very small gamble, perhaps about as likely as winning the lottery. But if you lose the lottery, you go on to live your life. Not so if you take your chances with the smallpox vaccine and lose.
The benefit of vaccination, of course, is being immunized from the deadly disease. Dr. Byron Weeks, a retired Air Force colonel, has told we need vaccinations now.
Moreover, here are the risks of doing nothing until the threat actually strikes. Smallpox has a 20 to 30 percent mortality rate. Short of death, side effects to smallpox include encephalitis or permanent neurological damage. No question that the risk of not doing anything is far greater than the risk of dispensing vaccine to the public.
Current plans call for stockpiling the vaccines until there is an outbreak. Not many health officials are calling for pre-emptive action. As of now, there are only 15 million doses on hand.
Dr. Weeks fears that by the time the gravity of a smallpox attack sinks in among political and military leaders, they will not dispense the stocks because once they are used up, there will be none for the military and the political elites. Thus, current government policy is to stockpile the vaccine, but not vaccinate the public.
Sen. Specter believes allowing people who are willing to go ahead with the vaccination and take the small risk to do so is just "common sense."
While government officials ponder the perceived dilemma of how to deal with a disease believed to be in the hands of terrorist countries such as Iraq, some Americans have considered going to Canada or Mexico to get vaccinated. They are not willing to wait until this time next year when it is expected that an additional 300 million doses will be available, even assuming massive vaccinations will be administered then. Some health officials are resisting the idea, although health workers are being vaccinated. This would lend credence to Weeks' fear that decision-makers are behind the curve on the urgency of action now.
Americans have learned that there are people out there willing to die in order to kill them. That is why there is a concern that terrorists (possibly some who are themselves infected) might be willing to assume the role of suicide killers to spread deadly diseases such as smallpox.
In the last 30 years, there have been robust debates over whether certain alleged dangers to human health and life are real or overblown. Scientific experts say the new terrorist war now presents the U.S. with life-threatening health risks that are definitely real. The only controversy lies in deciding exactly what to do about them.
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