Slow start for smallpox vaccine plan

Some states have inoculated thousands; others, few or none. Gaps in coverage could result, but these rates are not the only measure of preparedness.

By Victoria Stagg Elliott, AMNews staff. May 5, 2003.

During the past three months, some physicians and health care workers have stood in line, rolled up their sleeves, and received the smallpox shot -- thus becoming part of the cadre of men and women likely to respond in the event of a smallpox outbreak.

The lines, however, have been short.

More than 285,000 doses of smallpox vaccine were delivered to states for civilian use, as part of the Bush administration efforts to prepare the health system for possible bioterrorist-launched infection. But as of April 11, more than 30,000 vaccinations have been delivered, according to the Centers for Disease Control and Prevention.

"The numbers are definitely not where we would like them to be," said James J. James, MD, DrPH, MHA, director of the AMA Center for Disaster Medicine and Emergency Response. "But they have been increasing. Hopefully, we're dealing with a program that's more of a slow start than one that's not going to get to completion."

Most experts believe that initial expectations for the smallpox vaccination program were much too high, especially when considered in the context of various complicating issues. Liability and compensation questions, for instance, have only recently been resolved in Congress. Before this, some potential recipients opted out or were advised by their unions or employers not to get vaccinated. Others may have decided that the risks of the shot outweighed its benefits, especially for a disease that is not an immediate threat.