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PENTAGON PLANS SMALLPOX SHOTS FOR UP TO 500,000
By Judith Miller and Eric Schmitt
New York Times
Saturday, October 12, 2002
ith the Bush administration moving closer to military action against Iraq,
the Pentagon is expected to begin vaccinating up to half a million troops
against smallpox as soon as the vaccine is licensed in mid-November,
military and administration officials said today.
The officials said that leading military and civilian advisers to Defense
Secretary Donald H. Rumsfeld, as well as his top medical experts, had
recommended that the troops be inoculated.
The officials, familiar with the prolonged debate over whether to vaccinate
against the disease and if so, whom said Mr. Rumsfeld had not yet
approved the recommendation. But barring objections from the White House,
they said, that approval is all but assured. Soldiers would then be
receiving vaccine that would not yet be available to most civilians, because
of concerns about potential side effects.
Of the 1.4 million service members on active duty, 350,000 to 500,000 could
be immunized under the Pentagon's plan, officials said. Most would be in
units that might eventually be deployed to the Middle East, though others
would be inoculated as well.
"If you're talking about potentially sending troops to areas where they
could be exposed to smallpox," one senior military official said, "aren't
you negligent if you don't give them every possible protection?"
Vice President Dick Cheney, who was secretary of defense during the Persian
Gulf war of 1991, has been a strong advocate of vaccinating the troops,
administration officials say.
Like Mr. Cheney, members of the Joint Chiefs of Staff and top civilian
officials at the Pentagon, including Deputy Defense Secretary Paul D.
Wolfowitz, an influential proponent of a change of government in Iraq,
strongly favor vaccinating soldiers deployed to the Middle East even before
any case of smallpox is detected, Pentagon aides said today.
In the past week, Secretary Rumsfeld has also directed aides to help allies,
including those in the Middle East, acquire the vaccine and so protect
themselves against smallpox attack, a senior military official said.
Public health officials said recently that the Pentagon had already asked
the Department of Health and Human Services, the keeper of American vaccine
stockpiles, to set aside one million doses for United States military use.
Should the Pentagon go ahead with the vaccination program, members of the
military could be in the vanguard of mass smallpox inoculation. Government
health officials disclosed last week that they favored offering the smallpox
vaccine to the public even if there has been no bioterror attack, but not
until as many as 10 million health workers are immunized and a vaccine is
licensed for general use. They said this would probably not occur before
The White House is expected to announce soon whether civilians are to be
vaccinated. Officials said the decision had been difficult for President
Bush, given the probability that some people would die of the vaccine's side
The Defense Department recommendation favoring immediate vaccination of
soldiers who might be deployed to or near the Middle East caps a yearlong
policy review by the Pentagon.
The review has focused on assessing the probability that American soldiers
might be exposed to the virus that causes smallpox, a disease that was
declared eradicated more than 20 years ago. Historically, smallpox was one
of mankind's deadliest scourges, killing one-third of those it infected.
The Defense Department declined to comment today on the status of its
protracted review. But in interviews this week, Pentagon officials and
others said military scientists had recommended that soldiers be vaccinated
against smallpox regardless of what Mr. Bush ultimately decides is
appropriate for civilians.
Much of the reasoning at the Defense Department has dealt with the
presumption that Iraq has secretly kept strains of the virus that it could
use in a confrontation with the United States.
There are only two official repositories of the virus: the Centers for
Disease Control and Prevention, in Atlanta, and the Vector laboratory in
Novosibirsk, Russia. But intelligence analysts maintain that about a dozen
countries may be secretly harboring it, among them Iraq.
Those opposed to vaccinating soldiers before an actual case of smallpox is
discovered have argued that there is no conclusive proof that Iraq has the
virus or, even if so, is willing to use it in a bioterror or military
Those who favor immunization have argued that while scientific data show
that vaccinations given within four days of exposure to the virus can
prevent the disease, there are no readily deployable detectors that can
reliably signal the presence of the virus in an attack on a battlefield or
in a terrorist strike.
Scientists said the decision was difficult because the vaccine itself has
been known to cause life-threatening complications for 15 people of every
one million who are being vaccinated for the first time.
Neither troops nor public health workers and other "first responders" will
be inoculated until the Food and Drug Administration fully licenses the
Public health officials say the F.D.A. is now expected to license the first
million doses by the end of the first or second week of November, and
another million doses by the end of the month.
"No official in the Pentagon or the civilian sector is going to approve
immunization prior to the detection of a case of smallpox unless the vaccine
is fully licensed," a senior administration official said.
Although the vaccine was given to millions of people throughout the world
prior to 1972, it has not been administered to civilians since the World
Health Organization declared smallpox eradicated in 1980.
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