Just when America's anxiety level seemed to returning to normal, the folks at NBC are preparing to incite mass panic on a scale that hasn't been seen since Hillary Clinton threatened to nationalize the health care system. Tomorrow night on the season finale of the popular drama "ER," two children will be admitted to America's favorite hospital with small lesions covering their feverish little bodies. The feared diagnosis: smallpox.

Now close your eyes and imagine some not insubstantial portion of the 21 million people who watch "ER" each week clicking off their TV sets, turning to their spouses, and anxiously asking: "Honey, does this bump on my earlobe look funny to you?" Next thing you know, soccer moms are hyperventilating over little Timmy's diaper rash and stockbrokers with back acne are storming emergency rooms from Bangor to Baja.

OK, maybe not storming. But in these days of bioterror angst, even perfectly sane non-hypochondriacs get itchy at the mere thought of the "S" word. Back in the fall, when some sociopath with a chemical imbalance and a chemistry set was mailing anthrax-laced love notes up and down the East Coast, the media inundated us with countless "It could be worse, this could be smallpox" stories recounting in excruciating detail the viciousness of this (please, God) defunct scourge. Though it has only a 30 percent kill rate (compared with inhalation anthrax's awe-inspiring 80 percent), smallpox maintains a special grip on the imagination because of the ease and swiftness with which it can spread. No one likes to think that a stray sneeze from the chick next to him on the subway could be a ticket to an excruciating death, in which fluid-filled pustules explode over every inch of your body--including the inside of your nose, mouth, and throat--until the layers of skin separate and start sloughing off in big sheets at the slightest... Sorry, I digress. But if there's one thing that television knows how to do, it's transform our deepest, ickiest fears into prime time melodrama.

Public health officials know this, and many are bracing for an influx of calls in the wake of Thursday night's episode. Some agencies have prepared smallpox fact sheets to help address the most frequently asked questions. "We're going to have to be able to respond," George Handy, head of the Association of State and Territorial Health Officials told USA Today.

Of course, one of the most common inquiries from freaked out viewers is likely to be: Where can I get vaccinated against this stuff? Health officials generally prefer to avoid this question because of the answer they must give: You can't. The government stopped smallpox vaccinations three decades ago, shortly before the disease was eradicated from every corner of the globe. Every corner, that is, except for research labs scattered throughout the United States and the former Soviet Union, which, for all we know, have at some point been infiltrated by some sociopathic bin Laden wannabe who's now holed up in one of Saddam Hussein's guest houses, plotting to unleash this ancient evil on an unsuspecting and unvaccinated American public.

At present, our stockpiles of vaccine are unnervingly low, though the situation is improving. In the wake of September 11, the Bush administration ordered the vaccine manufacturers to get back in the kitchen and start cranking out enough juice to protect the entire population if necessary. Unfortunately, it remains to be seen whether the American public will actually be allowed access to that vaccine.

Although overwhelmingly effective and largely safe, the smallpox vaccine does carry some risk of side effects--including, in rare instances, death. As such, government officials are debating whether to allow precautionary vaccinations, or whether to hold back the shots and use them only for targeted, emergency vaccinations in the event of an outbreak. In fact, even as "ER" spooks a nation, the CDC is organizing a series of public forums at which the "to vaccinate or not to vaccinate" issue will be discussed. Afterward, a panel will make recommendations to a federal advisory committee. Presumably, Americans will then be told what is best for them.

Does anyone else find this debate offensive--particularly on the watch of a Republican administration? I'm sorry, but if a well-informed, tax-paying, mentally competent adult wants a smallpox vaccine, she should be allowed to have it. If the government is worried about costs, make people pay for the shots--and pad the price enough to subsidize shots for poor folk. If we're worried about supply, then let's have a debate about what it will take to procure enough vaccine to go around. But don't babble on about how the government must weigh the risks to individuals and make this decision for us as though we were small children. Tell people the odds and let them take their chances.

And all things considered, the odds aren't that bad. USA Today reports: "A recent study by University of Michigan researchers predicts smallpox vaccine given to Americans ages 1 to 65 would cause 4,600 serious illnesses and 285 deaths." And? We're talking about millions and millions of people here. Yes, it would be terrible if even one death resulted from a precautionary measure that might never be necessary. But what happens if people aren't given the vaccination option, and a half dozen terrorists some day manage to infect themselves and then decide to take a walking tour of Manhattan? Hey, if you're batty enough to crash a plane into a building, you're batty enough to spread a few deadly microbes before offing yourself.

Yes, there would be some education issues and practical challenges to address. If at all possible, we want to avoid outraged citizens suffering ill side effects and suing the government, whining that no one told them the risks. Of particular concern would be people with compromised immune systems, who face a much higher danger of severe side effects. They might want to opt out of inoculation entirely, as well as take precautions around friends who had just been vaccinated. But these are details that could and should be worked through so that the individuals can be given a choice.

Hey, maybe we'll be lucky. Maybe all remaining traces of the lethal virus are in the hands of safe, sane, responsible, pro-U.S. scientists. Or if there is an outbreak, maybe the ever-vigilant, always-efficient public sector will be able to contain and swiftly vaccinate every single infected person. Maybe. But it sounds like a sucker bet to me.