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Little resistance to smallpox shots expected

By Dave Moniz, USA TODAY

WASHINGTON — When the Pentagon begins inoculating troops with smallpox vaccine in the next few weeks, it is unlikely to encounter the resistance that erupted when the services administered anthrax vaccinations, military analysts say.

Facing an uncertain threat from the deadly smallpox virus, sources in the White House say Bush soon will announce plans to vaccinate 500,000 military personnel and 510,000 civilian medical workers.

Troops considered at highest risk are those who could be assigned to the Middle East in the event of war with Iraq, which is suspected of maintaining stocks of the smallpox virus. The initial vaccination plan also would cover troops in key homeland security roles.

"I think it would be a very small percentage of folks who would not want to take the shots," says Jim Martin, a retired Army colonel who teaches courses on military culture at Bryn Mawr College in Pennsylvania. "Most troops at this stage would consider this a natural consequence of military service."

Smallpox vaccine is administered in one injection. For every 1 million people vaccinated, 1,000 have adverse reactions that are not life-threatening; one or two die.

Earlier this month, Defense Secretary Donald Rumsfeld recommended that up to 500,000 U.S. troops be vaccinated for smallpox.

The Pentagon's experience administering anthrax vaccine to troops beginning in 1998 was mixed. The overwhelming majority of those ordered to take the vaccine did so and suffered no health problems, but the Defense Department's policy created a miniature revolt in the National Guard and Reserves.

Dozens of Air Force Reserve members and a handful of active-duty troops refused to take the vaccine, which is given in a series of six shots. Those refusing to take the anthrax vaccine claimed it had never been properly tested and could have adverse side effects.

Critics said as many as 400 Guard and Reserve officers refused to take the vaccine. Instead of protesting publicly, many quietly left the service rather than re-enlist. Two years ago, amid a congressional inquiry and controversy over plans to inoculate all 1.4 million active-duty troops, the Pentagon began to run out of vaccine and suspended the program. Inoculations resumed this year for a number of troops headed overseas.

Defense analysts and former military officers anticipate no revolt with the smallpox vaccine, for several reasons:

• Virtually every service member over 30 got a smallpox vaccination as a child. That familiarity, experts say, will go a long way to calming the fears of younger troops.
• The domestic anthrax attacks after Sept. 11 changed the attitudes of many military personnel about the threat from biological weapons. Until then, many Americans considered anthrax attacks only a remote possibility.
• The potential threat from smallpox and other biological and chemical weapons is underscored by the return of U.N. weapons inspectors to Iraq this week.

"We know that Saddam Hussein has ordered a bunch of antibiotics and huge quantities of Atropine, so biological and chemical weapons are a real threat," says David Grange, a retired Army general who served in the Persian Gulf War in 1991. "If I was going to be deployed over there, I'd want the smallpox shot."

Atropine and the antibiotic Cipro are recommended treatments for exposure to chemical and biological weapons, including anthrax. Iraq's large-scale purchase of antidotes to chemical and biological weapons has heightened fears that Saddam is willing to use such terror weapons against U.S. troops.

There is no cure for smallpox, a pathogen that kills about 30% of those infected. There have been no cases of smallpox since the late 1970s, but a handful of countries, including Iraq, are believed to have developed strains of the disease as a biological weapon.