Vaccines as a First Line of Defense

ATLANTA -- Officially, smallpox strains exist only in the legitimate World Health Organization repositories of Vector in Novosibirsk, Russia, and the national Centers for Disease Control and Prevention in Atlanta. But the people most familiar with the disease say they almost certainly exist in other places as well. Intelligence reports place the virus at the Russian military laboratories of Sergiyev Posad and perhaps elsewhere in Russia. Many believe North Korea has stores of the virus -- perhaps alluded to in that nation's announcement last week that it has continued to pursue nuclear weapons "and more."

About Iraq's bioweapons program there has been little but hints and rumors. Bioterror expert Michael Osterholm, formerly of the Minnesota Department of Health, reports that Jordan's late King Hussein told him "on his deathbed" that Iraq has the smallpox virus. Laboratory equipment labeled "smallpox" was found in 1994 by United Nations Special Commission inspectors, although Iraqi scientists said the equipment was used only to prepare smallpox vaccine. They admitted, however, to working with camelpox, a related virus that can be used as a stand-in for smallpox in the laboratory.

A declassified 1994 U.S. intelligence report states that the Soviets passed "technology relating to smallpox and anthrax" to North Korea and Iraq. The author of that report, a former intelligence officer who wishes to remain anonymous, told me that he did not mean that the virus itself had been passed to Iraq; "they wouldn't have done that," he insists.

Maybe. But, in any event, all this is circumstantial evidence, reported in the press for years. Now there is reason to believe the Bush administration has new cause for alarm about smallpox and Iraq. This alarm, whispered about in high circles, has caused a major policy change, quietly implemented in the last couple of weeks.

Despite the clear risks of the live smallpox vaccine, the Bush administration is moving as quickly as supplies become available toward offering voluntary smallpox vaccinations to the entire country.

Whatever the government now knows or suspects, the threat is real enough to eliminate most informed opposition to rapid voluntary immunization. The CDC, which has long promoted a strategy of "ring vaccination" aimed at containing an epidemic after it occurs, has dropped its reflexive opposition to the idea of pre-attack vaccination.