A different View of Smallpox Vaccination

In this article in the New England Journal of Medicine,  Thomas Mack, an epidemiologist, questions the Bush Administration's policy for smallpox vaccination.  He's got a good point:  for every 1,000,000 people vaccinated, 3 or 4 people will die as a consequence of vaccination.  Deaths from vaccine complications would outweigh any limited increase in protection, and since smallpox could be introduced anywhere — the likelihood that the right healthcare workers would be where the outbreak occurs is small.

Dr Mack argues that a much smaller (~15,000) sulset of healthcare workers be vaccinated, and that we do a good job educating both physicians and the public about signs and symptoms of smallpox.  This group would care for smallpox victims in separate healthcare facilities – limiting the risk of spreading the disease.