Bad decision on smallpox vaccinations

     The Bush administration appears poised to make a bad decision on smallpox by denying American citizens the right to protect themselves against that ancient scourge.
     The administration is reportedly considering a phased-in approach to smallpox vaccinations — offering them first to the emergency responders thought to be at highest risk of contracting the disease during an attack, and only later to the general public. The process could take years, even as the specter of a smallpox attack hangs over America.
     While the president has been busy with high diplomacy at the United Nations, it would appear that Beltway bureaucrats may have been responsible for the decision. The phased-in approach certainly has the air of arrogance — a hallmark of bureaucracy. The bureaucrats seem to believe that they alone should determine the appropriate levels of risk Americans should be willing to hazard from either a smallpox vaccination or a potential smallpox attack.
      But as Dr. William Bicknell of Boston University pointed out, "The more you do pre-attack, the easier it is post-attack." Indeed, each vaccination given to a volunteering American lowers the potential consequences of a smallpox attack — it reduces the number of Americans vulnerable to the disease, making containment that much easier; it also lowers the potential caseload of first responders, and it diminishes the possibility of a population-wide panic.
     While no one is certain how great the risk of an attack by smallpox is, according to Health and Human Services Secretary Tommy Thompson, "you have to assume the worst right now with bioterrorism." While the administration's desire to control the inherent risks of smallpox vaccinations is understandable (statistically speaking, the vaccine will kill about one of every million Americans exposed), it may have forgotten that those most at risk for a smallpox attack are not merely heath-care workers, but rather, all Americans.
      Moreover, Americans have long enjoyed a fundamental right to self-defense. Whereas they were once terrorized by tomahawk-wielding natives on the frontier, they are now threatened by vial-carrying extremists in the heartland.
      There will soon be enough smallpox vaccine to accommodate every American who wishes to take the controlled risk of being inoculated against the disease. They should be permitted to do so. In fulfilling its obligation to provide for the common defense, the administration must make the smallpox vaccine available to every American who wants it. The president should take a few minutes from his understandably busy schedule to be sure that his bureaucracy gets the smallpox vaccination strategy right.