- The Washington Times - Friday, December 13, 2002

After a difficult debate, President Bush is expected to announce today that he will permit all Americans eventual access to the smallpox vaccine. While certainly a step in the right direction, it still falls short of the sad necessity required by national security. Indeed, while it is laudable that the president has dragged the bureaucracy to this point, he will have to exert even more vigor to ensure that Americans' most basic rights are respected in this matter.

The necessity for an expedited smallpox inoculation campaign can be seen in newspaper headlines nearly every day. Rogue states have obviously acquired weapons of mass destruction like smallpox, and it's reasonable to assume that some of those weapons will fall into the hands of terrorist groups, if they have not already done so. "I think the risk of smallpox in the United States is increasing," Sen. Bill Frist pointed out at a recent news conference. "We should get going."

Voluntary public vaccinations are not a panacea for the problem, but they will certainly reduce the risk. "It's the right step to protect the American people, and it's the right step to make our nation less vulnerable to those who would use smallpox to terrorize our citizens," Mr. Frist said.

The administration's plan is expected to follow a tiered approach, based on likelihood of exposure. First to receive the vaccine will be front-line defenders 500,000 military personnel expecting duty in the Persian Gulf and another 500,000 or so health-care workers on emergency response teams and in hospitals around the country. The vaccine will then be offered to other health care workers and emergency responders. Members of the public aren't expected to be given the choice on smallpox inoculations until sometime in 2004. Those who want it sooner may be able to volunteer for clinical trials being set up by the federal government.

That's hardly an ideal solution. Clinical trials will be at best inconvenient for individuals hoping to protect themselves and their families as soon as possible. War clouds over Iraq are continuing to darken, and the threat of biological terrorism will only increase with time.

It comes down to a question of liberty. Americans have long enjoyed the liberty to make reasonable decisions on how best to protect themselves and their families the chance to make those choices is an important part of the unalienable rights with which they were endowed. With liberty comes responsibility, and there's no doubt that the choice to be inoculated against smallpox carries with it the small risk of adverse, and possibly fatal, consequences.

For that reason, the choice should be best left to individual Americans, who can best weigh the costs and benefits for themselves. Those living in area likely to be targeted by smallpox (D.C. residents come to mind) may be more willing to take the chance on vaccinations than those living elsewhere in the nation. That's fair. The point is that each individual must have the chance to make his or her choice on the matter as soon as possible.

When public vaccinations begin, the public, of course, will want to be informed of the possible risks. In the longer term, the research and development of a safer smallpox vaccine and smallpox antivirals will be required.

Mr. Bush is headed in the right direction on smallpox vaccinations. But he is not there yet.

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