Preparing for smallpox

Guidelines for inoculating the entire U.S. population against smallpox are being distributed to states today by federal health officials. At the moment mass vaccination is likely only if the deadly virus returns through an act of bio-terrorism. In the event of an outbreak, states would have to vaccinate their populations within days. (A person exposed to the virus can only be successfully immunized within five days of exposure.) The plan from the Centers for Disease Control and Prevention (CDC) shows states how to handle this massive effort, down to details like the number of hours a clinic would need to stay open (16), what to stress in public announcements (“urgency and patience, not panic”), the number of large-screens TVs needed per clinic (5, for video orientation), the temperature at which each brand of vaccine must be stored (varies), and the number of security personnel needed per 8-hour shift at a clinic (20). Smallpox is deadly, with a mortality rate of at least 30 percent. Because the disease was eradicated globally in the 1970s, most people have little immunity to it — and health workers aren’t familiar with it. Those facts plus the mobility of our plane-hopping poplulation mean that without extensive planning an outbreak could overwhelm public health systems.