about challenges that arose in the course of the vaccination program and about which the committee has written in previous reports, included here as Appendixes B-G. The fourth and final section highlights some of the favorable outcomes of the smallpox vaccination program.

In this chapter and elsewhere in this report, the committee has cited multiple articles from the mass media on the smallpox vaccination policy and on the program implementation. Using news media references was necessary because of the limited scientific peer-reviewed and other formal literature available on the newly initiated and continuing program. Although newspaper articles may capture events in a manner that is incompletely documented, subjective, and even out of context, the committee found that some themes emerged consistently from diverse media sources and provided useful information about how the program was perceived in the public health and health care communities. More important, mass media coverage of the program was concordant with the information presented at committee meetings by state and local public health officials and health care administrators, with the congressional testimony of public health leaders, and with findings from qualitative surveys that became available later in the course of the program. Mass media reports reflected the perceptions of key constituencies and the public; their perceptions of CDC, the program, and the federal government’s role may provide insight into the lessons to be learned from this program.


The Policy Is Announced

On December 13, 2002, President George W. Bush announced that smallpox vaccine would be administered to selected civilians and members of the military. The announcement was the culmination of planning and decision-making that spanned the latter half of 2002. The president explained that “government has no information that a smallpox release is imminent. Yet it is prudent to prepare for the possibility that terrorists would kill indiscriminately” with biologic weapons (White House, 2002b).

To prepare the nation for the threat of smallpox, the military vaccination program would provide mandatory1 vaccination to selected members


For designated military personnel without contraindications.

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