US public health doctors and preventive medicine specialists met in Atlanta, Georgia, last week to consider whether to continue the policy of prohibiting vaccinations against smallpox unless a smallpox bioterrorist attack takes place or whether to allow smallpox vaccination for anyone who wants it.
Dr D A Henderson, who led the worldwide smallpox eradication programme in the 1970s, and is now an adviser to Tommy Thompson, US secretary of health and human services, cited many problems if the smallpox vaccine were to be offered to all Americans. People with compromised immune systems, such as people with AIDS, and those with a history of eczema or atopic dermatitis are at risk from vaccination. A recipient of smallpox vaccine can infect another person by transfer of the virus by hand or through bathing. Other complications include post-vaccination encephalitis.
But Dr William Bicknell, professor of international health, sociomedical sciences, and community medicine at Boston University's School of Public Health, emphasised that relying on containment, tracing contacts, and isolation as the primary strategy to manage a malicious release of smallpox virus was very risky. He urged the CDC to seriously reassess its current policy.
Footnotes
For further information see www.cdc.gov