The government has announced that, in the event of a smallpox attack, the U.S. population could be vaccinated within 10 days. But what about in advance of an attack? In recent months, there's been increasing commentary about the right of every American to decide whether to be vaccinated. Do we know enough to exercise such a right responsibly? If we have a right to be vaccinated, pre-attack, are there circumstances under which we might have a duty to do so?
If the government's program to vaccinate health care workers goes well, and a sufficient quantity of the vaccine is licensed (sometime in 2004), it seems likely that each of us will be allowed to decide whether we want to be vaccinated. We need to be able, however, to weigh our personal risk of death and disability from the vaccine against the likelihood that we could get vaccinated "in time" should the nation be attacked.
In deciding whether to be vaccinated, we also need to weigh our personal risk of harm against the possibility that our being vaccinated may put others in harm's way.
- If smallpox were to be unleashed and some of us were already protected, our ability to rapidly vaccinate others might well improve.
- We might buy some time; having a proportion of the population vaccinated could slow the spread of the infection.
- There's a possibility that having a partially vaccinated population would make smallpox a less attractive weapon.
- Vaccinated individuals can transmit the vaccine virus to people who are already at increased risk of dying or suffering serious injury from the vaccine.
- It is unclear who will pay for the vaccine. Managed care? The federal government? And who should cover expenses that result from vaccine-related complications?
- The more of us who are vaccinated, the greater the costs and the greater the toll from vaccine-related complications. As the toll mounts, the greater the possibility of a backlash against all immunizations, including basic childhood vaccines.
For more information visit: www.bt.cdc.gov/agent/smallpox/index.asp