Few Volunteer for Smallpox Vaccination

WASHINGTON — The nation's largest population centers -- home to more than 30 million people -- have vaccinated only 296 front-line health-care workers against smallpox, the deadly disease that the Bush administration has pegged as a top bioterrorist threat.

The big cities, from New York to San Antonio, where the deadly smallpox virus could spread most easily and quickly, are proving to be among the hardest places to build a cadre of health-care workers prepared to respond to an outbreak.

Some administration officials are particularly angry that so few have volunteered. For every health-care worker who chooses not to be vaccinated, said an official who spoke on condition of anonymity, "more people will die in case of an attack."

On Wednesday, federal health officials remained perplexed as to why their high-profile anti-terrorism campaign had failed to catch on.

"We've been putting a lot of eggs in the vaccination basket and it hasn't gotten us a lot," said Joseph Henderson, associate director of terrorism preparedness and response at the national Centers for Disease Control and Prevention. "Right now, the vulnerability persists."

The administration tried last week to address one major concern: the fears of health-care workers that they would not be compensated for medical bills or sick time that could result from negative reactions to the vaccine. But the administration's proposed compensation package, now moving through Congress, appears to have had little immediate effect on workers' willingness to roll up their sleeves -- perhaps because, as administration officials now concede, they have overstated the vaccine's risk.

In addition, many nurses and doctors remain unconvinced that smallpox -- a disease not seen in the United States since 1949 and eradicated worldwide in 1980 -- could again become a major health threat.

Others want to volunteer, local officials say, but find themselves disqualified by health problems -- a history of eczema, for example -- that make the vaccine especially risky for them.

When the vaccination program began Jan. 24, the administration said its goal was to vaccinate 450,000 front-line health-care workers -- the doctors and nurses who, in case of a bioterrorist attack, would investigate suspected smallpox cases, treat the victims, track down their friends and relatives and administer the vaccine.