NCPA - National Center for Policy Analysis

Risks Of Smallpox Vaccinations

November 27, 2002

Should all Americans have the choice to receive smallpox inoculations? Or is widespread smallpox vaccinations a reckless idea?

Most Americans say (59 percent in a May 2002 poll) they would take the smallpox vaccine if it were offered, even after hearing that the disease was eradicated from nature decades ago and that the vaccine carries major risks.

However, the vaccine is not much improved from the one introduced in 1796, say experts.

  • It consists of a live vaccinia virus, a close relative of smallpox, and has little in common with much safer modern vaccines.
  • The vaccine can cause several severe side effects, including widespread infection of mucous membranes and the brain, and is expected to kill one to three out of every million people vaccinated.
  • The Centers for Disease Control and Prevention now recommends against giving the smallpox vaccine to anyone under age 18 unless an emergency already exists.

Some of the risks of smallpox vaccination are unknown. For example, drug companies are developing poxvirus-based vaccines against HIV, as well as therapies to fight many cancers. But Joanna Shisler, a University of Illinois virologist who works with smallpox vaccines, warns that those who receive the smallpox vaccine will develop a long-term immunity that will interfere with these newer poxvirus-based treatments.

Also, widespread smallpox vaccinations may cause substantial shortages in the U.S. blood supply if bloodbanks must wait before accepting blood from donors who have received smallpox inoculations.

In June, the panel of vaccine experts that advises the CDC recommended that the vaccine not be offered to the general population, particularly given the "low" probability of terrorists using smallpox.

Better to immunize only hospital workers and first-responders, say experts, then vaccinate more widely if an actual case is found.

Source: Henry I. Miller (Hoover Institution) and David Longtin, "Don't Offer All Americans Smallpox Vaccinations Now," USA Today, November 20, 2002.


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