CDC director denies existence of smallpox immunization program

In a sharp departure from previous public comments by senior federal officials, the director of the Centers for Disease Control and Prevention said Friday that the United States never launched a smallpox vaccination program this year, but instead worked toward an overall preparedness campaign.

Almost a year ago, CDC Director Julie Gerberding and Health and Human Services Secretary Tommy Thompson appeared to lay out the details of the nationwide smallpox vaccination program. In January, Gerberding prepared testimony for a Senate Health Committee hearing entitled "The Smallpox Vaccination Plan: Challenges and Next Steps."

In that hearing, she said health officials were planning to establish 1,500 clinics to deliver the vaccine and state authorities had identified "over 3,300 health care facilities that will participate in the program."

Last week, however, Gerberding said that the United States "didn't actually have a vaccination program, we had a comprehensive smallpox preparedness program."

She acknowledged that the United States "needed to have some pre-event vaccination of the people who would be most necessary to investigate smallpox cases and to treat the initial cases."

"In some states the immunization and all of the other comprehensive preparedness efforts have been successfully completed," she said.

Although the difference between an immunization program and a preparedness program might seem small, the CDC has been trying to play down expectations for the nationwide vaccinations after far fewer health care workers than expected volunteered to receive the smallpox vaccine. Officials expected to immunize as many as 450,000 health workers, but fewer than 40,000 have been inoculated. Several senior health officials have recently acknowledged that the program has fallen short of its goals, but no U.S. official has ever denied the existence of the immunization effort.

Friday, Gerberding said the United States "had a comprehensive smallpox preparedness program, and the goal of the smallpox preparedness program, at President Bush's direction, was to ensure that every jurisdiction in our country would be able to vaccinate their population within a 10-day time frame."

After President Bush announced the military smallpox immunization program last December, he said "we do recommend vaccinations for one other group of Americans that could be on the front lines of a biological attack. We will make the vaccine available, on a voluntary basis, to medical professionals and emergency personnel in response teams that would provide vaccine and treatment to Americans in a crisis."

Speaking later that day, Thompson said that 439,000 emergency medical workers were designated for vaccination in the program's first phase. Gerberding said that CDC officials were hoping to complete the initial phase quickly.

"In our planning guidance, we recommended that they try to accomplish this in 30 days from the point at which they actually open the clinics and begin the immunization," she said.

Experts and health officials have said that a key focus of the initial phase was to immunize health care workers who could then vaccinate others in the event of an attack. The ability to immunize every resident of the United States in 10 days - which Gerberding cited Friday as a key benchmark of the preparedness program - would require far more than 40,000 immunized health care workers, a public health expert said today.

An immunization effort on that scale and time frame would require 1.25 million immunized health care workers, according to Edward Kaplan, a Yale University professor who has been a vocal critic of the CDC's smallpox vaccination plans.

He also rejected Gerberding's claims that the CDC never launched a vaccination program or laid out specific goals for the number of health care workers to vaccinate.

"This is kind of like a fantasy land," he said.