WASHINGTON - After as many as 10 million health care workers and emergency personnel are immunized against smallpox, a licensed vaccine should be made available to all Americans who want it, the government's top public health officials said yesterday.
But the officials said their position did not necessarily reflect the Bush administration's view on who should be protected against a possible terrorist attack using smallpox. They stressed that President Bush had not made a decision.
"We represent the public health perspective, but the decision also has to be made on the grounds of homeland security and national security," Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, told reporters.
The United States stopped routinely vaccinating children against smallpox in 1972, and the disease was eradicated worldwide in 1980. But last year's terrorist attacks raised fears that the highly contagious virus, which kills almost a third of those infected, could be used as a biological weapon.
Since then, the administration has sharply increased the nation's vaccine supply. It determined that old stocks could be watered down, and it contracted with manufacturers for the fast-track production of millions of additional doses.
Federal health agencies are also working with state and local governments to develop mass immunization plans, and officials said yesterday that there was now enough vaccine for all Americans.
Because the smallpox vaccine protects individuals against the disease for up to four days after exposure to the virus, states should be able to vaccinate as many as 1 million people in the first 10 days after a smallpox attack, the CDC said last month.
What makes the pre-attack inoculation decision so difficult are the risks associated with the vaccine. Using vaccination data from the 1960s, scientists estimate that for every million people vaccinated the live virus will replicate in 900, causing complications such as rash, fever and body aches. About 15 people would develop encephalitis or other life-threatening conditions, and one or two of those individuals would die.