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Thursday, 12 December, 2002, 13:23 GMT
Bush backs smallpox jabs for all
Laboratory worker in hazardous materials suit
There is no known cure for smallpox
US President George W Bush has decided to revive a nationwide smallpox inoculation programme, beginning with the military and health workers who would be the front-line defenders in the event of a bio-terror attack.

Mr Bush is expected to announce further details of the plan on Friday, but it is thought that within weeks the Pentagon could begin vaccinating soldiers heading to the Persian Gulf.

The jabs will be given to half a million military personnel, and recommended for a further 500,000 people who work in hospital casualty units and on special smallpox response teams.

They will also be available on a voluntary basis to all 280 million Americans, but stockpiles for public use are not expected to be licensed until 2004.

Has existed for 3,000 years
Spreads through the air
Fatal in up to 30% of cases
No known cure
Vaccination before exposure or 2-3 days after offers almost complete protection
Vaccination 4-5 days after exposure may prevent death
US stopped routine vaccination in 1972
Adults vaccinated as children may no longer be protected
Vaccine can have serious side effects
Sources: CDC and WHO

In making the decision to go ahead with the programme, Mr Bush had to weigh the risks of the often-deadly disease against the dangers of the vaccine itself, which produces more serious side effects than any other vaccine dispensed in the US.

Based on studies from the 1960s, when inoculation was widespread, 15 out of every million people vaccinated for the first time will face life-threatening complications, and one or two will die.

Therefore statistically, if the entire US population was vaccinated, the vaccine itself would kill just under 200 people.

Smallpox was eradicated worldwide more than 20 years ago, but intelligence analysts believe that at least four countries, including Iraq, have illegal stocks of the virus.

'Ample information'

"I will have a detailed plan that the American people will digest," Mr Bush said in a US television interview on Wednesday.

"It's going to be very important for us to make sure there's ample information for people to make a wise decision," he said.

Barbara and Jenna Bush
Mrs Bush said she felt it would be safe to vaccinate her daughters
Despite the risks, a survey released on Wednesday said that two-thirds of Americans would have the vaccine if it was available.

When asked how she would feel about her daughters being vaccinated, the president's wife Laura said: "I would feel like that was certainly safe."

Routine smallpox vaccinations ended in 1972, meaning that nearly half the population is without any protection from the deadly virus - which has a mortality rate of about 30%.

'The right step'

Advocates of widespread vaccination say the programme will make enemies less likely to use smallpox as a weapon.

"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 terrorise our citizens," said Senator Bill Frist of Tennessee.

Smallpox has a 30% mortality rate
But others have reservations.

Dr D A Henderson, a bioterrorism adviser who led the global campaign to wipe out the disease, said: I must confess, I thought we'd seen the very last of smallpox vaccine."

Certain people - such as cancer patients, pregnant women, organ transplant recipients and those suffering from eczema or HIV - will not be able to take the vaccine because they face particular risk of side effects.

People living with those who have these conditions should also not be vaccinated, because the live virus used in the vaccine can sometimes infect others.

The BBC's Nick Bryant
"Polls suggest most Americans want the vaccine"
See also:

02 Dec 02 | Health
23 Sep 02 | Americas
03 Dec 02 | Health
29 Aug 02 | Health
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