- SAN DIEGO -- Scientists warned
over the weekend that widespread vaccination against smallpox in advance
of a terrorist attack could cause many more deaths than last fall's anthrax
attack, and, in an era of uncertainty, it may be up to each American to
decide whether to take the risk.
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- The warnings follow a report Friday that the Bush administration
plans to announce a policy to offer voluntary smallpox vaccinations to
thousands of hospital emergency care workers, health care providers, fire
and police personnel and, ultimately, all Americans in case an attack occurs.
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- Federal health officials here at an international meeting
of the American Society for Microbiology would not confirm that report
on Sunday. ''A number of policies are under consideration,'' said Julie
Gerberding, director of the Centers for Disease Control and Prevention.
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- White House spokesman Gordon Johndroe said no decisions
have been made. ''We continue to review and examine this issue.''
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- Some scientists and political leaders have said mass
vaccination could thwart a bioterrorist attack. But in June, a panel of
experts advised pre-attack immunization only for teams of health investigators
and hospital workers. Unless there is heightened risk of attack, the panel
concluded, the vaccine's side effects outweigh its benefits.
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- For every 1 million immunized, one or two people would
die from the vaccine, Anthony Fauci, director of the National Institute
of Allergy and Infectious Diseases, said Sunday. About half of those vaccinated
for the first time suffer muscle aches or fever. Serious side effects were
rare during mass vaccinations in the 1960s, he said, and complications
in people being revaccinated were even more rare. It's estimated that 64%
of today's workforce probably was vaccinated before 1972, when routine
smallpox vaccination ceased.
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- But it's a different world today. Ronald Atlas, president
of the microbiology society, said 20% to 25% of those who suffered reactions
were people who had not been vaccinated but caught the vaccine virus from
recently immunized people. Today, with so many more cancer patients, people
with HIV/AIDS and others with weakened immune systems, the number of serious
side effects could be ''much higher, by orders of magnitude.''
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- ''If someone told me we were going to be attacked tomorrow,
I'd be the first to favor mass vaccination,'' Atlas said. But ''as long
as the perceived risk is low, risking the death of hundreds, to thousands,
of Americans is not a step I'd endorse. We have to assume the vaccine will
kill more people than last fall's anthrax attack,'' in which five died.
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- The implications of vaccine side effects may not be widely
understood, said Michael Osterholm, a special adviser to Health and Human
Services Secretary Tommy Thompson. ''I would like to see universal smallpox
vaccination,'' he said. ''It would be the first time in history we would
eliminate a bioterrorist threat. But at what price?''
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