- The Washington Times - Wednesday, August 7, 2002

JERUSALEM Israel has begun preparations for vaccinating its 6 million people against smallpox, fearing a biological attack from Iraq or other enemies if the United States strikes at Saddam Hussein's regime.
Health officials say there has been no decision yet on mass inoculation. However, hundreds of volunteers, mainly from the health sector, have been vaccinated to provide an adequate supply of antibodies that would be needed to treat side effects and complications stemming from the vaccinations.
These volunteers received vaccinations as children and are receiving booster shots. Vaccinations in Israel were stopped in 1979, when the World Health Organization announced that the disease had been eliminated.
The United States is also considering mass immunization.
Since the September 11 attacks, there has been growing fear that terrorists might resort to biological attacks, particularly with smallpox, which is highly contagious and sometimes fatal.
This fear is felt even more strongly in Israel, which believes that an American attack on Iraq might induce Saddam to fire missiles with biological warheads at Israel.
In the 1991 Persian Gulf war, Iraq fired at Israel 39 missiles with conventional warheads. There is also fear that an extremist Islamic organization might attempt to use biological weapons against Israel.
There is hesitation about mass inoculation because of the danger that a small percentage of the population might die from the vaccination itself.
According to Dr. Marvin Shapira, head of the infectious-diseases department at Hadassah Hospital in Jerusalem, one death can be expected for every million vaccinated, and there is danger of one case of brain infection for every 200,000 to 300,000 vaccinated.
Another health official said the number of people adversely affected by vaccination could range from 70 to 700.
About half the population of Israel was inoculated as children. Dr. Shapira said it is not clear whether these people would still be protected, because it is not known how quickly the effects of the vaccine wear off. It is most likely, he said, that such people, if exposed to the disease, would become ill, but not die.
"But the question is still open," he said. Health authorities recommend that if inoculation is conducted, it be extended as well to those who were vaccinated as children.
Israel has "close to enough" smallpox vaccine, said Dr. Boaz Lev, director-general of the Health Ministry.
He said a new vaccination method in use in the country requires doses only one-fourth or one-fifth of those given in the past and is just as effective. In an emergency situation, the population could be inoculated in four days, he said.
"The bottleneck is not the quantity of vaccine," he said, "but the fact that in order to embark on large-scale vaccination, we need antibodies to treat side effects."

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