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http://www.nytimes.com/2002/06/30/opinion/L30POXX.html

Smallpox Vaccine: Who Should Decide?

o the Editor:

Re "How to Prepare for a Smallpox Attack" (editorial, June 23):

As a practicing pediatrician in the Washington area, I have found it difficult to explain to my patients' families why they cannot obtain smallpox vaccinations. Other vaccines have risks and benefits, and families from all socioeconomic backgrounds are used to making these choices.

You call for a voluntary smallpox vaccination program for all Americans. This would give people the right to make an educated choice about smallpox vaccination. Each day we evaluate the risks and benefits of our actions, from taking medications to driving on the highway. The choice for a voluntary smallpox vaccination should be no different.

It is unwise for the government to include some and exclude others in prevention of a dread disease.
  MARJORIE BARNETT, M.D.
Silver Spring, Md., June 25, 2002
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To the Editor:

Re "How to Prepare for a Smallpox Attack" (editorial, June 23):

As a nonvoting attendee at the meeting of the Centers for Disease Control and Prevention committee that made the recommendation that the smallpox vaccine be made available only to certain laboratory researchers and those expected to respond to a bioterror attack, I think several points should be considered.

The committee made a public health decision, not a strategic one. It made the assumption that the risk of a smallpox virus release is low and agreed that any change in the risk should result in a re-evaluation of the recommendation.

Letting individual citizens decide whether they want to take the smallpox vaccine could cause millions of people to develop a skin lesion containing a virus that can spread to others. If those bystanders have an altered immune system from cancer, chemotherapeutic drugs or AIDS, the result could be a life-threatening or life-ending infection.
  ROBERT S. BALTIMORE, M.D.
New Haven, June 26, 2002
The writer is a professor of pediatrics and of epidemiology and public health, Yale University School of Medicine.
 

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