News Release

September 5, 2003

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Stalled Smallpox Plan Needs Shot in the Arm
CDC guidelines overstate risk; government ill-prepared in case of bioterror attack

WASHINGTON -- Although President Bush's December 2002 smallpox vaccination plan is sound, the program is stalled. Even though there is enough vaccine on hand, the government is ill-prepared to rapidly contain smallpox after a bioterrorist release, according to a new Cato Institute study.

In "Smallpox and Bioterrorism: Why the Plan to Protect the Nation Is Stalled and What to Do," Dr. William Bicknell and Kenneth Bloem, respectively, a former commissioner of Public Health in Massachusetts and a former CEO of Stanford University Hospital and Georgetown University Medical Center, argue that the Centers for Disease Control and Prevention have overstated the risk of vaccine side effects and erroneously claim that, should an attack occur, the techniques used decades ago to eradicate smallpox will work well today.

"In our judgment, the best policy guidance that the CDC can offer is: If you are a healthy adult who does not worry about driving to work, you should not worry about getting vaccinated or accidentally vaccinating another person," Bicknell and Bloem write, adding that a healthy adult is 42,000 times more likely to die from an accident in the next 10 years than from a smallpox vaccination.

The authors list three key reasons for why the plan is stalled: inadequate and confusing information about the risk of smallpox vaccination; the executive branch was slow to propose and put in place liability coverage should serious complications occur; and surprising silence from leaders in the administration during a critical period. These reasons, combined with the risk-averse culture prevalent in the public health establishment, have led to a perception that the plan is not a high priority. They recommend that because smallpox is as much a national security matter as it is a public health issue, the Department of Homeland Security and the White House need to revitalize the National Smallpox Vaccination Program. At the very least, far better information about the vaccination risk, along with a clear rationale for the president's plan, is a must.

"Because the speed of post-event vaccination is directly dependent on the number of vaccinators willing to expose themselves to the risk of smallpox, the smaller the number of immunized vaccinators, the faster smallpox would spread across the country," Bicknell and Bloem write. "Further, if neither health care workers nor the general population are immunized, our hospitals and medical care system will be at grave risk of being swamped and losing significant capacity after a smallpox attack. That is exactly what the president's plan was designed to prevent."

"Smallpox and Bioterrorism: Why the Plan to Protect the Nation Is Stalled and What to Do,"