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Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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SCIENTIFIC AND POLICY CONSIDERATIONS IN DEVELOPING SMALLPOX VACCINATION OPTIONS

A WORKSHOP REPORT

Board on Health Promotion and Disease Prevention

INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS
Washington, D.C. www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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THE NATIONAL ACADEMIES PRESS
500 Fifth Street, N.W. Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This study was supported by the Centers for Disease Control and Prevention. The views presented in this report are those of the Institute of Medicine Committee for a Forum on Smallpox: The Scientific Basis for Vaccination Policy Options and are not necessarily those of the funding agencies.

International Standard Book Number 0-309-08604-3

Additional copies of this report are available from the
National Academies Press,
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Copyright 2002 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Cover: Transmission electron micrograph (TEM) of Orthopoxvirus variola viruses. Magnification: x50,000 at 6 x 4.5cm size. Alfred Pasieka/Science Photo Library/Photo Researcher.

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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“Knowing is not enough; we must apply. Willing is not enough; we must do.”

—Goethe

INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES

Shaping the Future for Health

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M.Alberts is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm.A.Wulf is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V.Fineberg is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M.Alberts and Dr. Wm.A.Wulf are chair and vice chair, respectively, of the National Research Council

www.national-academies.org

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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COMMITTEE FOR A FORUM ON SMALLPOX: THE SCIENTIFIC BASIS FOR VACCINATION POLICY OPTIONS

STUART BONDURANT (Chair),

The University of North Carolina, Chapel Hill

RONALD BAYER,

Columbia University, New York

GEORGE ISHAM,

HealthPartners, Inc., Bloomington, Minnesota

KATHLEEN TOOMEY,

Georgia State Health Department, Atlanta

ROBERT B.WALLACE,

University of Iowa, Iowa City

Staff

CATHARYN LIVERMAN, Senior Program Officer

KATHLEEN STRATTON, Senior Program Officer

JUDITH ESTEP, Senior Project Assistant

ROSE MARIE MARTINEZ, Director,

Board on Health Promotion and Disease Prevention

RITA GASKINS, Administrative Assistant,

Board on Health Promotion and Disease Prevention

KATHI E.HANNA, Writer, Consultant

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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INDEPENDENT REPORT REVIEWERS

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:

Kenneth Bloem, Georgetown University Medical Center, Washington, DC

K.Lynn Cates, Rainbow Babies and Children’s Hospital, Cleveland, Ohio

Frank J.Fenner, Australian National University, Canberra, Australia

Patricia A.Nolan, Rhode Island Department of Health, Providence, Rhode Island

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions nor did they see the final draft of the report before its release. The review of this report was overseen by Bronwyn Schrecker, Manager of Report Review for the Institute of Medicine. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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Suggested Citation:"Front Matter." Institute of Medicine. 2002. Scientific and Policy Considerations in Developing Smallpox Vaccination Options: A Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/10520.
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At the World Health Assembly in May 1980, the World Health Organization declared the world free of smallpox. Smallpox vaccination of civilians is now indicated only for laboratory workers directly involved with smallpox or closely related orthopox viruses. However recent questions raised by the terrorist attacks in fall 2001 have renewed concerns about possible outbreaks of smallpox resulting from its use as a biological weapon. In June 2002, the Institute of Medicine convened a public conference to discuss the scientific, clinical, procedural, and administrative aspects of various immunization strategies. Scientific and Policy Considerations in Developing Smallpox Vaccination Options summarizes the presentations and discussions from this workshop.

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