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http://www.nytimes.com/2002/12/26/international/middleeast/26ISRA.html

Israel Will Expand Its Smallpox Vaccinations, but Not to Everyone

By DEXTER FILKINS

ERUSALEM, Dec. 25 — Israeli officials said today that they had decided against vaccinating the entire population against the smallpox virus. But they said they were expanding the number of soldiers and health care workers who would be vaccinated to 40,000 or more.

The officials said they made the decision after concluding that the likelihood of a smallpox attack, by terrorists or another country, was slim. A more realistic goal, they said, was to ensure that the country's doctors and nurses could carry out a crash program to inoculate the entire population quickly if a single case of smallpox were discovered. The officials said they hoped they could vaccinate the entire population of six million Israelis in about four days if the need arose.

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"Intelligence reports are saying there is no immediate threat, and we don't see the possibility of Iraq attacking us with smallpox," said Dr. Yehuda Danon, professor of immunology and pediatrics at Tel Aviv University. "But everything could change once we have the first case."

The decision was announced amid a flurry of press reports here speculating on the dangers of a biological or chemical weapons attack in the event of a war with Iraq. The Israeli smallpox program has been closely watched in the United States, where the Bush administration recently started a campaign to vaccinate as many as 10 million health care and emergency workers and 500,000 soldiers. The American program has prompted concerns that the vaccines will kill or harm a number of people, but Israel uses a less virulent strain and officials say they have kept the vaccine's side effects to a minimum. The Israeli government has already vaccinated about 17,000 people, and so far only two people have suffered ill effects from the vaccines. Both of them recovered, the officials said.

Israeli officials said they decided to expand the pool of those receiving vaccinations to include more health workers, police and soldiers. The larger group of people receiving the vaccine, the officials said, would provide a larger supply of plasma with which to treat those who suffer complications.

"The first single case of smallpox would change the daily life of the whole country and probably the whole world," Dr. Danon said. "Air and sea transportation would stop. We have to make sure that we have a population who can treat the sick people and immunize healthy people."

Smallpox was declared eradicated by the World Health Organization in 1980. Until then, it killed about a third of those it infected.

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