Smallpox vaccination of police officers, firefighters and paramedics should continue despite an advisory panel's recommendation last week that the inoculations be stopped, the CDC said Thursday.

Dr. Julie Gerberding, director of the Atlanta-based Centers for Disease Control and Prevention, said states should keep expanding vaccination campaigns to include first responders.

Health care workers were initially targeted in the campaign, which started in January. They were to be followed by first responders.

Some areas, such as Florida, Hawaii and New York City, have started offering the vaccine to the second group.

The CDC's Advisory Committee on Immunization Practices said last week that only health care workers should continue getting the shots, citing cases of heart attacks and heart inflammation among some vaccine recipients.

But Gerberding said Thursday the continued threat of bioterrorism makes the original vaccination program necessary.

"We respect the ACIP perspective, but we also recognize that we still have work to do, including ongoing immunization," Gerberding said.

Georgia, which has vaccinated 142 health care workers, won't decide whether to offer the vaccine to first responders before August, said Richard Quartarone, spokesman for the Georgia Division of Public Health.

About 38,000 health care workers nationwide have received the vaccine, well short of the 500,000 goal that also called for up to 10 million first responders to be immunized.

More than 450,000 military personnel have gotten the shots. At least 50 people in the military and 22 civilians have encountered swelling of the heart or the lining around the heart. Three heart attack deaths were reported in March.

Researchers don't know if those conditions are tied to the vaccine or to the general risk for heart disease among Americans.

States are now screening out people at risk for heart disease in the smallpox vaccine campaign, Gerberding noted.

The CDC had projected one to two deaths, up to 52 life-threatening side effects and as many as 1,000 milder reactions for each 1 million vaccinations.