March: Biodefense & food supply safetyU.S. smallpox preparedness improves, even if not quite according to plan

Published 10 March 2008

The number of people vaccinated is vastly lower than President Bush projected, but public health experts say that there are enough healthcare workers inoculated to respond to an outbreak and enough vaccine on hand to get more protected, along with anyone else exposed to the disease

A federal initiative launched in 2003 to vaccinate healthcare workers against smallpox reached only a fraction of the people it sought. Veterans of the effort say, however, that elements of the Bush administration’s plans, such as stockpiling vaccine and training medical personnel to treat the disease, have made the nation much better prepared to respond to a bioterrorism attack. The smallpox programs were implemented as part of a broader strategy at the federal, state and local levels to protect the nation after the 9/11 attacks. The federal government has spent billions of dollars on acquiring drugs and vaccines, increasing hospital and laboratory capacity, training healthcare workers and developing detailed plans for reacting to an attack using biological agents such as smallpox or anthrax. The Hill’s Jeffrey Young writes that despite all the attention placed on smallpox back in 2003, less than one-tenth of those President Bush proposed inoculated have received the vaccine. “We are much better prepared than we were,” said Eric Toner, a senior associate at the Center for Biosecurity at the University of Pittsburgh Medical Center in Baltimore who has criticized the vaccination program. The government has stockpiled more than 200 million doses of smallpox vaccine, for example, Toner and others noted. “If we would have a [single] smallpox case tomorrow … we can probably handle it,” said Georges Benjamin, executive director of the American Public Health Association. “But if we had a terrorist attack with smallpox, it would still be a challenge,” he added.

Congress and the administration dramatically increased public health funding for agencies such as the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to finance the efforts on multiple fronts. Even though those initiatives were broad, Bush paid special attention to smallpox. In December 2002 Bush made a high-profile announcement of a program to inoculate as many as 500,000 healthcare workers and other first responders against smallpox, a devastating disease that was officially declared eradicated from the globe in 1979 but is considered a major threat for terrorism. There have been no cases of smallpox in the United States since 1949 and routine vaccinations were halted in 1972. Bush and federal health officials were concerned about the possibility that terrorist organizations would obtain some of the existing laboratory samples of smallpox kept on hand for research purposes in the United States and the former Soviet Union. The highly