Sixty percent of Americans would opt for smallpox immunization if the vaccine were available, according to a recent poll, and U.S. health officials have just negotiated the purchase of enough vaccine for everyone in the United States. Those two facts may be a prescription for bad medicine.

Medically and epidemiologically, smallpox is the most feared and potentially devastating of all infectious agents. It spreads from person to person, primarily via droplets coughed up by infected persons, via direct contact, and from contaminated clothing and bed linens. Smallpox is fatal in approximately a third of previously unvaccinated persons who contract the disease.

For weeks, the media have raised the specter of terrorists using smallpox virus as a weapon. The German government has bought six million doses of vaccine, and pressure is mounting in the United States for widespread, or even universal, vaccination. (Routine smallpox vaccinations ceased in this country in 1972.)...

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