After purchasing an expanded stockpile of smallpox vaccine to prepare for the threat of bioterrorism, the federal government is reviewing who should have access to it. Current policy favors administering smallpox vaccinations only after confirmation that an outbreak has occurred, rather than making the vaccine more broadly available to the American public. Other policy experts favor leaving it up to individuals to weigh the benefits of protection against the risks of dangerous side effects from vaccination. Preemptive vaccination on a broad scale provides a third option. Join our panel in a wide‐ranging examination of the rationale behind alternatives that will affect our lives and our health.