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Smallpox: Immunization Program Falters, But Threat Remains By David McGlinchey “I don’t think there is any question that the need is still there for us to have a plan in place,” said House Select Intelligence Committee member Richard Burr (R-N.C.), who sponsored legislation in April designed to jumpstart the faltering vaccination effort. Some public health experts agreed that the United States must continue to prepare for a possible smallpox attack. “The threat is there … until the intelligence committee tells us it’s gone I’m unwilling to say it is gone, or decreased,” said William Bicknell, a Boston University professor and an authority on immunization planning. In December, U.S. President George W. Bush announced the immunization campaign, which was intended to inoculate 500,000 civilian health care workers in “phase one” and another 10 million emergency workers in the second phase. Health officials said they wanted to reach the 500,000 mark by the end of February, but only 37,000 health workers had been immunized by early June. The campaign has not yet officially moved into phase two. Burr sponsored a bill to compensate those sickened by the potentially harmful vaccine, a long unresolved issue that was keeping volunteers away from the program (see GSN, May 1). Bush signed the bill into law last month, and lawmakers were hopeful for a swell in volunteers, but a quick end to the war in Iraq took momentum away from the effort, according to some officials. The threat of a smallpox attack goes beyond Iraq, according to Bicknell and Kenneth Bloem, a senior fellow at the Johns Hopkins University Center for Civilian Biodefense Strategies. In a soon-to-be-released paper from the CATO Institute, the two say that health officials should not allow the vaccination campaign to die. “The smallpox risk has never been thought to be limited to the [Saddam] Hussein regime … as was true before the Iraq war, the decision regarding post-Iraq smallpox risk is for the intelligence community to assess, not for medical and public health personnel,” the paper says. Last week, the New York Times reported that only 100 volunteers, nationwide, are receiving the vaccine each week and Burr said the program had stumbled out of the gates and had never recovered. “Clearly we are not going to have the pool that we first thought we would,” Burr said. Faced with low numbers of immunized health workers, Bicknell and Bloem called on the Bush administration to rejuvenate the campaign. They also recommended the establishment of an advisory panel “to assure that bioterrorism response plans are adequate,” according to their report. Burr said the United States must explore new technologies to improve biological defenses. “We need to continue to look at alternatives that allow us to address an attack in a timely fashion, I don’t want us to look at the vaccination program as the only method to prepare for an attack,” he said. Burr offered strong support for Project Bioshield — a $6 billion, 10-year effort to stockpile medicines and technologies to respond to a bioterrorist attack. He said that the effort, proposed by Bush in his January State of the Union address, could advance promising new efforts. The bill is currently in the House of Representatives (see GSN, May 23).
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