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By Peter Gorner
Tribune science reporter
Published December 14, 2002

President Bush unveiled his much-anticipated smallpox vaccination plan Friday and said he would be vaccinated along with U.S. troops who might be put in harm's way, but that the vaccine is too risky for most Americans.

Consequently, his family and staff--including Vice President Dick Cheney and the Cabinet--would not be immunized for the time being, the president said.

"There is no reason to believe that smallpox presents an imminent threat, but it is prudent to prepare for the possibility," Bush said.

While recommending that average citizens not get the vaccine, Bush said it would be made available to the public as soon as next spring, many months earlier than previously suggested.

If terrorists unleashed smallpox on the U.S., the government has now stockpiled sufficient quantities of smallpox vaccine "to vaccinate every single person in the country in an emergency," the president said.

Starting within weeks, an estimated 500,000 military personnel and others in what Bush called "high-risk parts of the world" will be vaccinated against smallpox.

Some United States personnel assigned to certain overseas embassies also will be offered vaccination.

"By mid-January, we will be vaccinating fairly large numbers of troops considered to have mission essential capabilities that we need to protect," said Ed Wyatt, principal deputy assistant secretary of defense for health affairs.

The smallpox vaccine, which was routinely administered to Americans until 1972, has proved to be a highly effective protection against the disease when given before or shortly after exposure to the virus.

Vaccination of military personnel was conducted during both world wars and routinely from the 1940s until 1984. Between 1984 and 1990, vaccinations were given to many recruits when they entered basic training.

As had been reported earlier, Bush ordered the Department of Health and Human Services to work with state and local governments to form volunteer Smallpox Response Teams. In order for them to be able to mobilize immediately in case of an emergency, health care workers and other critical personnel will be asked to volunteer for immunizations against smallpox.

Vaccination carries rare but serious side effects. According to some estimates, at least one or two out of every 1 million people will die from the vaccine, and 15 will face life-threatening complications.

It remains to be seen how U.S. troops will respond to the president's directive. In 1997, the military ordered 2.5 million active duty personnel to be inoculated against anthrax. Many troops refused the anthrax vaccine because of reported side effects, including fever, muscle pain and dizziness.

Anthrax vaccine generally causes milder reactions than smallpox vaccine.

The Bush administration has for months been debating whether to offer smallpox vaccinations to the public. Advisory committees have counseled the president not to release the vaccine unless there's a national emergency.

Bush compromised Friday. He said he could not offer the vaccine to some Americans but not to all.

The president ordered public health agencies to work to accommodate people who want to be vaccinated, and according to the Centers for Disease Control and Prevention, the vaccine could be available as early as spring.

The new genetically engineered smallpox vaccine should be licensed and available by 2004. An educational campaign will explain smallpox vaccine's risk in detail, officials said.

"We're going to gear up gradually on this program," said Dr. D.A. Henderson, principal science adviser to Health and Human Services Secretary Tommy Thompson.

"The first phase will begin in late January. The states have told me they identified 435,000 volunteers--public health and medical response teams--most likely to come in contact with smallpox victims," Henderson said. "That's the priority group in the first phase. The second phase will involve more traditional emergency first responders--fire, police, EMS, and other health care providers--at somewhat less risk.

"The eligible group for vaccination would be about 10 million people. How many of them elect to be vaccinated? Our guess is about half those asked--5 million people."

Tom Schafer, spokesman for the Illinois Department of Public Health, said the state plans to vaccinate 8,000 to 16,000 health care and emergency response workers. There are 93 health departments in the state and 152 hospitals.