- The Washington Times - Friday, July 5, 2002

Criticizing my commentary (“Small thinking on smallpox,” June 20), Jerome M. Hauer of the Department of Health and Human Services writes that the Centers for Disease Control and Prevention (CDC) held public forums in New York City, San Francisco, San Antonio, St. Louis and Washington (“HHS is thinking big on smallpox,” Letters, June 28). True enough. But these forums were hastily put together, not widely advertised to the public and consequently not very well attended.

That hardly constitutes a wellspring of public opinion and input as part of the decision-making process for smallpox vaccination policy particularly when the CDC made clear well in advance of the final Advisory Committee on Immunization Practices (ACIP) meeting in Atlanta on June 19-20 the policy direction in which it was heading, regardless of limited public input.

He also expresses concern over the possible transmission of the smallpox vaccine live virus to individuals who may develop life-threatening complications. Certainly, Mr. Hauer is aware that such instances are very rare and generally the result of household contact or children-to-children contact. This can be mitigated by the use of a semipermeable membrane dressing that prevents viral shedding. A self-quarantine is another option, and a decision could be made not to vaccinate children under a certain age (e.g., 5 years old, 9 years old).

Ultimately, Mr. Hauer demonstrates that his mind-set is still one of looking at smallpox as a public health problem to be handled by a small priesthood of “experts” when he writes that “the health of the American public must be our primary concern.” He fails to appreciate or understand that smallpox bioterrorism is a national security problem and that the responsibility of the federal government is to protect the public from and prevent future terrorist attacks, including those potentially using the deadly smallpox virus.

So while the CDC's limited number of hastily arranged public forums meant that its largely predetermined policy recommendations were not made “behind closed doors,” the thinking of its ACIP was driven by closed minds.


Senior defense policy analyst

Cato Institute


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