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http://www.nytimes.com/2002/12/15/health/15VOIC.html?tntemail0

Reaction Is Mixed to Smallpox Inoculations

By DONALD G. McNEIL Jr.

ear of smallpox, fear of its vaccine. Worried about Baghdad, worried about Washington. Even before President Bush on Friday announced plans to vaccinate civilian health care workers and military personnel and make the vaccine available to the public as early as next year, many Americans were wrestling with these issues: Is smallpox really a threat, and is a risky ounce of prevention worth it?

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Anthony Burrows, 38, a United Parcel Service driver from Brooklyn, was not eager to be inoculated. "I'm not taking it," said Mr. Burrows as he dropped off boxes in Midtown Manhattan. "This whole thing is politics and big business. Somebody stands to make a bundle off the vaccine."

Mr. Burrows said he would not have his children vaccinated either. He said he did not like the idea of being injected with a disease to fight another disease. And, he said, he was not afraid of a germ attack even though his job theoretically made him vulnerable, like the postal employees who contracted anthrax.

Others had the opposite reaction.

"I would take it, and my kids would too," said Linda Massina of La Plata, Md., who was a few blocks away, headed for Radio City for a Rockettes performance. Her 20-year-old son can make his own decision, Mrs. Massina said, but the three younger children will be getting the shots. "We knew people who were lost at the Pentagon." Mrs. Massina said. "We see the effects of terrorism here in New York. There was already that subway attack in Japan with that sarin or whatever."

Mr. Burrows and Mrs. Massina represented two ends of a spectrum of decision and indecision that seemed to waver across the nation. Some people were sure they would take the vaccine, some were sure they would not — but most were just not sure.

The president's announcement that he himself would be vaccinated against smallpox because he is commander in chief, but that his family would not be, seemed to leave some people confused.

"It's a very curious message — `I'll set an example but my family is not going to get inoculated,' " said Bob Schatz, a wholesale bookseller from Portland, Ore., visiting Houston on business. "What is he telling us? If we are supposed to, then show leadership. If it's an ill-defined thing that could happen, there are a million things that could happen."

Julia Schreiber, 37, an accountant and mother of four in Houston, said she would get vaccinations only if the state required it or her company, Reliant Energy, strongly recommended it. Even then, Mrs. Schreiber said, she might do as she does now with the flu, have herself vaccinated but not her children.

There were a fair number of people who thought that the whole debate was a waste of time, that no smallpox attack was imminent.

"Saddam Hussein has been described as evil, but not suicidal," said Dr. Franklyn N. Judson, director of public health for Denver. "His main interest is staying in power. I guess if they ever had it, they've probably gotten rid of it."

Although he is a professor of preventive medicine at the University of Colorado and one of those in charge of Denver's response to any outbreak, Dr. Judson, 60, said he personally would not recommend that anyone in Denver — including his own family — get a smallpox shot now.

"There's no benefit," he said. "The chances that somebody will show up in Denver or Rangely, Colo., with smallpox is so vanishingly small. It's a virus that's not known to exist but in two laboratories."

Tina Getsee, 41, a police crime statistician in Coral Springs, Fla., with five sons aged 4 to 18, said she was not worried about the vaccination itself since her children had had others with no problems. But she was also not worried about a smallpox attack. "I don't think they would attack here," Mrs. Getsee, said. "I think they would hit major cities. I feel fairly safe."

In a poll taken in October, sponsored by the Robert Wood Johnson Foundation and released only last week, 65 percent of all Americans said they were ready to be vaccinated against smallpox. In a similar poll taken by the foundation in May, 59 percent said they were.

In Los Angeles, Janice Black, 56, said she, too, might get revaccinated. "If it saves my life, I'd put up with three days of sickness," Mrs. Black said. "It sounds dangerous, but where was the danger when everybody was taking it years ago?"

Shauna Harrington of Watertown, Mass., shopping with her young daughters Zoe and Enya, said she thought that immunizing soldiers made sense, but having herself or her daughters vaccinated did not.

At Kaiser Permanente Medical Center in Los Angeles, Dr. Coleen Sintek, 51, a cardiac surgeon, and Dr. Marjorie Bernstein Singer, an oncologist, both argued against precautionary vaccinations, saying they believed there was enough time to vaccinate after an attack started.

Dr. Sintek said she would not get the vaccine herself, noting that a lot of patients had compromised immune systems and that contact with the site of her vaccination could put them at risk. Dr. Singer, speaking of Mr. Bush, said she felt "the whole thing is a scare tactic to get people to support his policy."

The chief of the emergency room in North General Hospital in Harlem, Dr. Neal M. Shipley, said he did not plan to get vaccinated because he has a 14-month-old child at home. Dr. Shipley said he found the president's decision to ask emergency personnel to be vaccinated "very frustrating."

He said, "We have real patients, with real problems — diabetes, high blood pressure, domestic assault — right now."

Many of those in the military who were interviewed said they were not worried about vaccinations and would willingly be inoculated. On Friday, a few marines at Camp Pendleton, near San Clemente, Calif., sat around a barbershop and talked about the president's announcement.

One of them, Cpl. Eric Pinkston, 23, of Salida, Colo., said of getting vaccinated: "I'm all for it. Given a choice of a vaccine or dying from anthrax or smallpox, I'll take the vaccine."

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