In the mid-1950s, AIDS did not exist, chemotherapy was in its infancy, and people with genetic immune deficiencies died. At that time, smallpox was a genuine health threat and vaccinations were required, for some people once every three years. Everyone carried a World Health Organization (WHO)-approved vaccination card with their passports. Parents needed them when their children changed schools.
Today's world bears little resemblance. Many people are immunocompromised: cancer patients; those awaiting organ transplants and patients with rheumatoid arthritis require immunosuppressive steroid regimens; between 850,000 and 950,000 Americans have HIV; and the number of elderly people, who have less robust immune responses, has increased. Genetic immunodeficiencies are diagnosed in children before their first birthday. In the United States, smallpox vaccinations ended some 30 years ago, as did most research. The last known case of naturally occurring smallpox was in 1977.1
But in this post-Sept. 11, 2001 world, the Bush administration ...
