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The system would include pre-vaccination screening and educational programs; database tracking and checkups of those immunized; access to government-stockpiled medication to treat side effects; and a 24-hour-a-day helpline staffed by experts.
   Although all vaccines are scrutinized for safety, the smallpox monitoring system will be the largest ever. The vaccine can cause severe side effects and even death for some of its recipients.
   "We always think about any untoward events" regarding vaccines, said Dr. Myron Levin, a member of the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.
   "But I think here we're pushing ahead faster than usual; the timetable has been moved up because of national safety and security concerns."
   The monitoring is needed, experts say, because most smallpox vaccine data ended when routine vaccinations stopped in 1972 in the United States. And the system, which is initially intended for the first wave of health care workers to be immunized, will provide crucial safety data on how people reacted to the shot and logistical experience to vaccine experts should the entire American population need the vaccine.
   "We rarely vaccinate 500,000 people at once," Levin said.
   Concerns that rogue nations might have access to smallpox, a virus that was declared eradicated from the world two decades ago, has prompted the White House to consider making smallpox vaccine available to health care workers and the public.
   No decision has been made. But the ACIP earlier this week recommended that about 510,000 hospital workers be immunized. Federal health officials have suggested offering shots to about 10 million health care workers and eventually making the vaccine available to the public.