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Issue Number 355            December 18, 2002


  1. President Bush announces national plan for smallpox immunization


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December 18, 2002

On December 13, President Bush presented the national strategy for smallpox immunization. A statement of the plan, taken from the website of the Centers for Disease Control and Prevention (CDC), is reprinted below in its entirety.



December 13, 2002

Today, the President announced a plan to better protect the American people against the threat of smallpox attack by hostile groups or governments:

  • Smallpox Response Teams
    Under the plan, the Department of Health and Human Services (HHS) will work with state and local governments to form volunteer Smallpox Response Teams who can provide critical services to their fellow Americans in the event of a smallpox attack.
    To ensure that Smallpox Response Teams can mobilize immediately in an emergency, health care workers and other critical personnel will be asked to volunteer to receive the smallpox vaccine.
    The federal government is not recommending vaccination for the general public at this time. There may be some members of the general public who insist on being vaccinated now. Our public health agencies will work to accommodate them, but that is not our recommendation at this time.
  • Department of Defense and State Department Personnel
    The President also announced that the Department of Defense (DOD) will vaccinate certain military and civilian personnel who are or may be deployed in high threat areas. Some United  States personnel assigned to certain overseas embassies will also be offered vaccination.


Although there is no reason to believe that smallpox presents an imminent threat, the attacks of September and October 2001 have heightened concern that terrorists may have access to the virus and attempt to use it against the American public. Immediately after these attacks, HHS began working, in cooperation with state and local governments, to strengthen our preparedness for bioterror attacks by expanding the national stockpile of smallpox vaccine. The United States currently has sufficient quantities of the vaccine to vaccinate every single person in the country in an emergency.

The smallpox vaccine, which was routinely administered to Americans until 1972, is a highly effective protection against the disease when given before or shortly after exposure to the virus. Pre-attack  vaccination of Smallpox Response Teams will allow them, in the event of a smallpox attack, to immediately administer the vaccine to others and care for victims.

HHS is working with states to identify health care workers and first responders to serve on Smallpox Response Teams. Pre-attack vaccination of these Smallpox Response Teams will allow them to better  protect the American public against smallpox attack.

The federal government is not recommending that members of the general public be vaccinated at this point. Our government has no information that a biological attack is imminent, and there are significant  side effects and risks associated with the vaccine. HHS is in the process of establishing an orderly process to make unlicensed vaccine available to those adult members of the general public without  medical contraindications who insist on being vaccinated either in 2003, with an unlicensed vaccine, or  in 2004, with a licensed vaccine. (A member of the general public may also be eligible to volunteer for an on-going clinical trial for next generation vaccines.)


The President also announced that DOD will take steps immediately to reinstitute vaccination of certain military and civilian personnel. Those personnel who are deployed or who may deploy to certain high  threat areas will be vaccinated. The State Department will also offer vaccination to certain overseas personnel.

Although the vaccine is effective if administered shortly after exposure, it may not be feasible during an emergency to vaccinate overseas troops and civilian personnel. Pre-attack vaccination is therefore  warranted. Vaccination of military personnel was conducted during WWI and WWII and routinely from the 1940s until 1984. Between 1984 and 1990, vaccinations were provided to many recruits entering basic training.


To access an HTML version of the statement, go to:

To access a camera-ready (PDF) version, go to:

To access the full text of the president's remarks, go to:

To access the seven-minute audio of the remarks, go to:

To access the seven-minute video of the remarks, go to:

To access Frequently Asked Questions about the national smallpox plan from the White House website, go to:

To access Frequently Asked Questions about smallpox disease and vaccine from the CDC website, go to:

To access a camera-ready (PDF) version of Frequently Asked Questions from the CDC website, go to:  

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IZ Express is supported in part by Grant No. 1NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of and do not necessarily represent the official views of CDC.

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