Caution on Mass Vaccination

The recent anthrax attacks, along with concerns about even more bioterrorism, have alerted health officials to be better prepared to protect the public.

But it is the few contagious threats, such as the possibility of terrorists spreading smallpox, that really concern officials. A proposed government remedy should also concern many Americans.

States, which have the constitutional mandate to safeguard public health, are being urged to prepare for mass vaccinations against smallpox (see story, page 1).

That's an understandably cautionary move against such a threat. But the means of carrying it out also should be cautiously considered. The government still needs to explain how it will balance many individual concerns about being vaccinated against the collective interest in preventing a smallpox epidemic.

Individual choice vs. the state

The vast majority of states have laws which respect individual rights on most medical issues, especially in this age when alternative means of healthcare, such as prayer, are becoming more widely accepted and proving so effective.

Many individuals also are concerned about expert estimates that a mass inoculation might kill a few hundred people, or damage many more. Will government accept those potential deaths for the sake of potentially saving millions?

A public debate is needed to answer that question. Even now, many people are seeking redress for government-required vaccines that have harmed or killed loved ones.

Still, if an emergency such as an outbreak of smallpox should occur, cooperation should be the rule among the population, along with the obvious effort to minimize ill effects.

Lack of readiness

Absent a fuller understanding of the effects of biological attacks and appropriate responses, the federal Centers for Disease Control's current "ring" system for dealing with a bioterror attack - addressing only individuals who've come into contact with someone infected - makes more sense than mass inoculation at this point of national readiness. Many states still lack resources for such steps as mass vaccinations and mass quarantines. Some don't have adequate means to even test for a variety of chemical or biological agents.

Much more coordination between all public health agencies is still needed to handle a major bioattack. Giving too much authority to any single entity would be the wrong path.

One lesson already learned from the October anthrax attacks: Public health officials and the media need to work assiduously to prevent an epidemic of fear that can hinder a proper response to bioterrorism.

Knowing that government is well-prepared, delivering accurate information, and respects individual concerns about vaccines, should help reduce those fears.

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