MISSING IN ACTION - Federal Smallpox Planning
by Tom Holsinger
October 8, 2002

Federal plans for mass smallpox vaccinations are fatally deficient - they're a prescription for national suicide if an epidemic starts, and might kill thousands unnecessarily if one doesn't. Officials won't admit (a) their inadequate baseline health data for secondary infections, (b) the catastrophically short incubation period of terrorist smallpox using enhanced bioengineered Soviet cultures, and (c) that the American people might force hasty, dangerous mass vaccinations if safer phased vaccinations are delayed.

Smallpox vaccinations create flu-like symptoms and a small oozing sore, usually for a few days but sometimes up to several weeks. Up to 10% of Americans with certain medical conditions (chiefly impaired immune systems) should not be vaccinated due to excessive susceptibility to complications. They are similarly at risk from contact with pus from the inoculation sores of other persons. Thousands might die of secondary infections contracted from the sores of others absent careful, phased, implementation of mass vaccinations.

Reported plans nowhere mention the vast age/occupational differences between the groups proposed to be vaccinated today versus those in the past. Almost everyone inoculated prior to 1972, when mass civilian smallpox vaccinations ceased, were either pre-school children or military personnel, not active civilian adults.

Children with flu-like symptoms from vaccinations stayed at home, while the military personnel were either new recruits confined to barracks, or simultaneously subjected to so many other vaccinations just before overseas deployment that they felt awful and tended to stay in their quarters for a few days afterwards. I.e., they didn't circulate among the general public while infectious with open inoculation sores. But ALL the groups proposed for initial vaccinations will be active civilian adults and, when voluntary vaccinations are permitted, most of those vaccinated will be too.

Studies of the secondary infection risk have considered the much greater proportion of the immune-impaired today as opposed to 1946-72, while ignoring the vanishingly small numbers earlier of recently vaccinated active civilian adults; i.e., they focus on the wrong side of the risk such that the baseline data used for planning is inadequate. Health and Human Services Secretary Tommy Thompson should consider the implications of this.

The threat posed by vaccination of ten million health care workers and emergency service personnel is minimal. These are the most medically responsible American civilians, and so most likely to wear the special bandages for oozing inoculation sores which almost completely protect vulnerable bystanders from escaping pus.

The general public is a different story. No means presently exists to refuse voluntary vaccinations to those most likely to harm others with their inoculation sores. There are lots of truly irresponsible people out there. The mentally ill, etc., won't wear those special bandages anymore than they'll do the other things normal adults do, but even those who can care for themselves will briefly menace the immune-impaired. Some will do so deliberately. Planning for such legal, moral and political challenges is missing in action.

Federal planners' failure to recognize the inadequacy of baseline data concerning secondary infections pales by comparison with their refusal to admit the true degree of the terrorist smallpox threat. They persist in post-attack vaccination plans based on the natural smallpox incubation period of 10-12 days though they've known for years that the Soviet Union produced hundreds of tons of weaponized smallpox using enhanced bioengineered cultures with an incubation period of only 1-5 days. There are only a few vials of natural smallpox culture in carefully guarded locations compared to hundreds of pounds of former Soviet weaponized smallpox culture with indifferent or no security, so mere number-crunching shows that the latter is the threat to plan against.

Our present post-attack plan calls for thousands, or hundreds of thousands, of people to wait in line for a day or days to be vaccinated at each of a limited number of big medical facilities. This is an ideal means of ensuring that everyone is exposed to smallpox upon being vaccinated, and Soviet military smallpox has 60-90 percent morbidity with 30-50 percent lethality. Vaccination requires 2-3 days to become effective if it "takes" the first time (my wife's didn't), and will usually protect against simultaneous exposure to natural smallpox (10-12 day incubation period). But Soviet military smallpox has a 1-5 day incubation period, so 30-50 percent of those exposed to it will contract smallpox before vaccination can be effective.

This too raises questions about the competence and credibility of federal smallpox vaccination planners.

We know Iraq has successfully weaponized anthrax, has an active smallpox biowar program, has obtained former Soviet biowar experts as consultants, and has for years sought to obtain Soviet nuclear and biological weapons. Searching for these will be a priority for our forces when we occupy Iraq. If we find Soviet military smallpox there, we must assume Al Qaeda terrorists have it too.

It would then be insane not to commence voluntary mass vaccinations, but events and public demand might not permit an orderly, safe, phased program. Elected officials will comply if a terrified public demands immediate action, whereupon thousands of the vulnerable will die unnecessarily.

Management of public opinion is critical to avoiding the latter, and should start immediately. Confidence in the government's ability to protect us must be created if we are to avoid a panicky vaccination program which will kill more Americans than 9/11 even if no smallpox attack occurs. That would be doing it to ourselves.

The government's record here is dreadful. A classic example is a press release during last year's anthrax attack stating that there was no cause for alarm while urging everyone who had visited the Senate Hart Office Building in the past month to get Cipro at once.

The officials responsible for suicidal vaccination plans based on obviously inadequate secondary infection baseline risk data should have no further responsibility for public health. We don't need terrorists to kill thousands of Americans with biological weapons when we have the CDC on our side.