- The Washington Times - Tuesday, October 8, 2002

As this page has repeatedly advocated, the debate about allowing Americans to be voluntarily vaccinated against smallpox appears to have shifted from the question of "if" to the question of "when." Last Friday, Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention and Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, publicly acknowledged they support such a policy. Over the weekend, senior White House officials confirmed to the Associated Press that the administration plans to offer the vaccine to the public.

It is a welcome development, even though the timing, and the potential staging of such a policy remain uncertain. Some officials, including Vice President Dick Cheney, are pushing for public vaccinations as soon as possible, while other public-health officials want to use a tiered approach, first offering the vaccine to those first-responders thought to be most vulnerable to a smallpox attack, and then, when it is fully licensed, (probably around 2004) to the general public.

Sooner would almost certainly be better than later, given both the vast vulnerability of the American populace and the magnitude of the potential threat. Still, there are dangers on both sides. As Ms. Gerberding pointed out, even the licensed vaccine will cause an average of 15 life-threatening complications, and one or two deaths per every million Americans vaccinated. Individuals who were previously vaccinated should be at somewhat lower risk, but it is virtually impossible to say how much so.

There's no way around the fact that uncertainties underlie aspects of the vaccination debate. However, as Ms. Gerberding pointed out in last Friday's briefing, "We live in a society that values individual choice … Informed people may want to have the choice of getting vaccine or not."

That is certainly the case, and it is good to see that the administration has acknowledged it.

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