FIGURE 3-1 Timeline of smallpox vaccination program with number of weekly vaccinations and key events.

SOURCE: Henderson (2003b).

*MMWR = Morbidity and Mortality Weekly Report.

**ACIP = Advisory Committee on Immunization Practices.

  • Late March and early April 2003—Concerns about vaccine and program safety reach high point in response to reported fatal cardiac adverse events and cases of heart inflammation, known as myo/pericarditis.

  • April 2003—Smallpox vaccination compensation plan is enacted in response to widespread concern about vaccine-related injuries.

  • April 2003—General Accounting Office (GAO, now Government Accountability Office) report provides first systematic assessment of vaccination program progress and highlights challenges.

  • May 2003—Department of Health and Human Services (DHHS) makes supplemental funding available for smallpox vaccination program.

  • May and June 2003—Monkeypox outbreak tests public health (and smallpox) preparedness.

  • June 2003—Advisory Committee on Immunization Practices (ACIP) recommends ending smallpox vaccination after completing vaccination of response teams; vaccination continues, very slowly approaching 40,000 vaccinees.

The section on program milestones is followed by a discussion of two noteworthy features of the program (congressional interest and involvement, and the significance of the parallel military smallpox vaccination program). The chapter’s third section focuses on the committee’s findings



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