Just a few months after President Bush said he wanted 500,000 emergency workers to receive smallpox shots, the Centers for Disease Control and Prevention now says that 50,000 vaccinations might be a more reasonable target. Only 35,000 people have rolled up their sleeves to date.
Sources say the government is doing an about-face and will let states stop administering the high-risk vaccine, if they choose, reports CBS News Correspondent Sharyl Attkisson.
Local health agencies near the nation's capital are considering a shift of strategy from vaccinating people now to giving the shots immediately following an attack, The Washington Post reports. Smallpox vaccine can be effective four days after a patient is exposed.
That approach would clear one obstacle: motivating the patients. The absence of terrorist activities for several months, and the passing of the war in Iraq without a biological or chemical attack on the United States or its troops, has many people unwilling to take the risk of getting the vaccine. In extremely rare cases, it can have deadly side effects.
Dr. Brian Strom of the University of Pennsylvania School of Medicine heads the independent advisory committee that urged the government to slow – or stop – its program.
"This is a toxic vaccine. We should only use it in people who need it," says Strom. "And we need a few weeks or months to just step back and say let's re-plan the plans to see how many people need to get the vaccine before we continue on with it."
The problem is that if an outbreak occurs, a bear minimum of workers must be vaccinated so they can administer the vaccine to others. But since the vaccine doesn't always work the first time, and can trigger mild to severe side effects in some people, waiting until an attack has occurred carried significant risks.
But Daniel Lucey, director of the Center for Biologic Counterterrorism and Emerging Diseases at Washington Hospital Center, said an outbreak is like "a ticking clock. The sand is going down the hourglass, and every hour counts."
Some health workers have been reluctant to get their shots because it was unclear what would happen if they became ill or died from the vaccine. On April 30, the president signed the "Smallpox Emergency Personnel Protection Act of 2003" which allows federal compensation of health workers who get sick or die from the vaccine.
Yet another obstacle to getting volunteers is reports of serious and unexpected adverse events in the first people to get the shots.
An aggressive government surveillance program set up to detect any dangerous trends recently uncovered one: 11 cases of unusual heart inflammation among military troops who got the smallpox vaccine; three civilian deaths are also under investigation.
But CBS News has learned of one high-profile death that hasn't yet been counted – that of NBC Correspondent David Bloom. He died of an apparent blood clot several weeks after getting both the smallpox and anthrax vaccines.
Asked if an individual death that occurred within a matter of weeks a smallpox vaccination should have been reported, Strom said, "Yes."
The link between the smallpox vaccines and blood clots like Bloom's isn't widely accepted in the medical community, but has been claimed for years by some researchers. All adverse events are required to be reported so researchers can look for new, dangerous trends and see whether the vaccine may be at fault.
Strom says it would be "a surprise if we did not see new adverse reactions emerge."
Bloom's case may have mistakenly gone uncounted because civilians are being monitored under a civilian system and the military is tracking the troops. But it's unclear who – if anybody – is tracking the hundreds of civilian journalists who embedded with the military during the war with Iraq.
Bloom's case would make four deaths under investigation for a possible link to the smallpox vaccine. Already considered the riskiest of its kind, the smallpox vaccine may be even more dangerous than anyone thought.