BOX 2-1
CDC’s Draft Policy Options

CDC asked ACIP to consider three questions and develop options under each. The results of its deliberations, presented as options, follow each question. The following two questions refer to pre-event vaccination. A third question about postevent vaccination options is not provided below.

Question 1: With no known cases of smallpox worldwide, should there be any change in the current recommendation for not vaccinating members of the general public?

Option 1: In the absence of a confirmed smallpox case or a confirmed smallpox bioterrorism attack, ACIP does not recommend vaccination of members of the general public (i.e., no change from the current recommendation).

Option 2: In the absence of a confirmed smallpox case or a confirmed smallpox bioterrorism attack, ACIP does not recommend that members of the general public be vaccinated; however, members of the general public may choose to be vaccinated. (This is a negative recommendation by ACIP, but there is choice by members of the public.)

Option 3: In the absence of a confirmed smallpox case or a confirmed smallpox bioterrorism attack, ACIP recommendations for smallpox vaccine do not now include members of the general public; however, members of the general public may choose to be vaccinated. (ACIP is neutral, and there is choice by the public.)

Option 4: In the absence of a confirmed smallpox case or a confirmed smallpox bioterrorism attack, ACIP recommends vaccination for those members of the general public who decide to receive the vaccination.

Question 2: In addition to laboratory workers who work with viruses related to smallpox, are there other individuals in specific occupational groups who should be vaccinated to enhance smallpox preparedness? If so, what guidelines should be used to determine which individuals should be vaccinated?

Option 1: In the absence of a confirmed smallpox case or a confirmed smallpox bioterrorism attack, ACIP does not recommend pre-exposure vaccination for any individuals other than laboratory or medical personnel who work with non-highly attenuated orthopox viruses.

Option 2: In the absence of a confirmed smallpox case or a confirmed smallpox bioterrorism attack, ACIP recommends smallpox vaccination of persons predesignated by the appropriate bioterrorism and public health authorities who have responsibility for direct contact or investigation of the initial cases of smallpox.

Option 3: In the absence of a confirmed smallpox case or a confirmed smallpox bioterrorism attack, ACIP recommends extending Option 2 above to include smallpox vaccination of “essential” medical and non-medical service personnel predesignated by the appropriate bioterrorism and public health authorities.

SOURCES: ACIP (2002); IOM (2002b).



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement