U.S. President George W. Bush plans to announce tomorrow that military personnel and emergency workers will soon begin receiving smallpox immunizations, the New York Times reported today.  The vaccine will be available in 2004 to all U.S. residents who want it, administration officials said (see GSN, Nov. 25).

“I think it ought to be a voluntary plan,” Bush said in an ABC News interview broadcast yesterday.  “In other words, I don’t think people ought to be compelled to make the decision which they think is best for their family.  And what’s going to be very important is for us to make sure that there’s ample information for people to make a wise decision,” he added.

The United States plans to immunize up to 1 million military and emergency personnel in the first wave of vaccinations, which might begin in the next few weeks, administration officials said following the broadcast.

The television report seemed to surprise at least some top government health officials.

“We have no confirmation of the policy decision yet,” said Julie Gerberding, the director of the Centers for Disease Control and Prevention.  The CDC is currently evaluating smallpox immunization plans that states and large cities have submitted, she said (see GSN, Dec. 10).

“We have almost all the states’ plans and we are very pleased with the preliminary evaluation of them,” Gerberding said.

The administration has not decided, however, what to do about public demand for smallpox vaccine before sufficient stocks are licensed.  Officials can simply withhold the vaccine until 2004 — when sufficient amounts are expected to be available — or they can label the vaccine as an “investigational new drug” and make it available only to those who have a compelling need, according to the Times.

“The question is what do you do about John Q. Public between now and when licensed vaccine is widely available,” said a source familiar with the administration’s smallpox policy debate.  “That’s what the president hasn’t decided,” the source added (Stevenson/Altman, New York Times, Dec. 12).

“Preparing the emergency response teams is the highest priority,” an administration official said.  “Americans who feel they would like to be vaccinated will have access to it,” the official added.

Bush and his wife, Laura Bush, briefly addressed concerns about the vaccine’s side effects and said they would be comfortable having their 21-year-old twin daughters inoculated.

“If the vaccine were available, which I think it will be, I would feel like that was certainly safe for them to do,” Laura Bush said.  “I know there’s a slight risk.  That’s what people weigh when they make the decision whether or not to have their children vaccinated,” she added.

Meanwhile, the administration has come under fire for signing the Homeland Security Bill, which protects vaccine producers from lawsuits, without creating a compensation fund for those who suffer side effects from immunization, according to the Washington Post.

“Forcing people who are trying to do the right thing for the country to take care of themselves is wrong,” said Vermont Governor Howard Dean, a doctor and a Democratic presidential contender (Ceci Connolly, Washington Post, Dec. 12).

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