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.
The untold story of how America's Progressive-era war on smallpox sparked one of the great civil liberties battles of the twentieth century. At the turn of the last century, a powerful smallpox epidemic swept the United States from coast to coast. The age-old disease spread swiftly through an increasingly interconnected American landscape: from southern tobacco plantations to the dense immigrant neighborhoods of northern cities to far-flung villages on the edges of the nascent American empire. In Pox, award-winning historian Michael Willrich offers a gripping chronicle of how the nation's continentwide fight against smallpox launched one of the most important civil liberties struggles of the twentieth century. At the dawn of the activist Progressive era and during a moment of great optimism about modern medicine, the government responded to the deadly epidemic by calling for universal compulsory vaccination. To enforce the law, public health authorities relied on quarantines, pesthouses, and "virus squads"-corps of doctors and club-wielding police. Though these measures eventually contained the disease, they also sparked a wave of popular resistance among Americans who perceived them as a threat to their health and to their rights. At the time, anti-vaccinationists were often dismissed as misguided cranks, but Willrich argues that they belonged to a wider legacy of American dissent that attended the rise of an increasingly powerful government. While a well-organized anti-vaccination movement sprang up during these years, many Americans resisted in subtler ways-by concealing sick family members or forging immunization certificates. Pox introduces us to memorable characters on both sides of the debate, from Henning Jacobson, a Swedish Lutheran minister whose battle against vaccination went all the way to the Supreme Court, to C. P. Wertenbaker, a federal surgeon who saw himself as a medical missionary combating a deadly-and preventable-disease. As Willrich suggests, many of the questions first raised by the Progressive-era antivaccination movement are still with us: How far should the government go to protect us from peril? What happens when the interests of public health collide with religious beliefs and personal conscience? In Pox, Willrich delivers a riveting tale about the clash of modern medicine, civil liberties, and government power at the turn of the last century that resonates powerfully today.
The seventh edition of the Canadian Immunization Guide was developed by the National Advisory Committee on Immunization (NACI), with the support ofthe Immunization and Respiratory Infections Division, Public Health Agency of Canada, to provide updated information and recommendations on the use of vaccines in Canada. The Public Health Agency of Canada conducted a survey in 2004, which confi rmed that the Canadian Immunization Guide is a very useful and reliable resource of information on immunization.
In 1980, the World Health Organization (WHO) officially declared that smallpox had been eradicated. In 1986, WHO's international Ad Hoc Committee on Orthopox Virus Infections unanimously recommended destruction of the two remaining official stocks of variola virus, one at the Centers for Disease Control and Prevention and the other at the VECTOR laboratory in Siberia. In June 1999, WHO decided to delay the destruction of these stocks. Informing that decision was Assessment of Future Scientific Needs for Variola Virus, which examines: Whether the sequenced variola genome, vaccinia, and monkey pox virus are adequate for future research or whether the live variola virus itself is needed to assist in the development of antiviral therapies. What further benefits, if any, would likely be gained through the use of variola in research and development efforts related to agent detection, diagnosis, prevention, and treatment. What unique potential benefits, if any, the study of variola would have in increasing our fundamental understanding of the biology, host-agent interactions, pathogenesis, and immune mechanisms of viral diseases.
“The bard of biological weapons captures the drama of the front lines.”—Richard Danzig, former secretary of the navy The first major bioterror event in the United States-the anthrax attacks in October 2001-was a clarion call for scientists who work with “hot” agents to find ways of protecting civilian populations against biological weapons. In The Demon in the Freezer, his first nonfiction book since The Hot Zone, a #1 New York Times bestseller, Richard Preston takes us into the heart of Usamriid, the United States Army Medical Research Institute of Infectious Diseases at Fort Detrick, Maryland, once the headquarters of the U.S. biological weapons program and now the epicenter of national biodefense. Peter Jahrling, the top scientist at Usamriid, a wry virologist who cut his teeth on Ebola, one of the world’s most lethal emerging viruses, has ORCON security clearance that gives him access to top secret information on bioweapons. His most urgent priority is to develop a drug that will take on smallpox-and win. Eradicated from the planet in 1979 in one of the great triumphs of modern science, the smallpox virus now resides, officially, in only two high-security freezers-at the Centers for Disease Control in Atlanta and in Siberia, at a Russian virology institute called Vector. But the demon in the freezer has been set loose. It is almost certain that illegal stocks are in the possession of hostile states, including Iraq and North Korea. Jahrling is haunted by the thought that biologists in secret labs are using genetic engineering to create a new superpox virus, a smallpox resistant to all vaccines. Usamriid went into a state of Delta Alert on September 11 and activated its emergency response teams when the first anthrax letters were opened in New York and Washington, D.C. Preston reports, in unprecedented detail, on the government’ s response to the attacks and takes us into the ongoing FBI investigation. His story is based on interviews with top-level FBI agents and with Dr. Steven Hatfill. Jahrling is leading a team of scientists doing controversial experiments with live smallpox virus at CDC. Preston takes us into the lab where Jahrling is reawakening smallpox and explains, with cool and devastating precision, what may be at stake if his last bold experiment fails.
December 13, 2002, the president of the United States announced that smallpox vaccination would be offered to some categories of civilians and administered to members of the military and government representatives in high-risk areas of the world. The events that precipitated that historic announcement included a series of terrorist attacks during the 1990s, which culminated in the catastrophic events of 2001. Although preparedness for deliberate attacks with biologic weapons was already the subject of much public health planning, meetings, and publications as the twentieth century neared its end, the events of 2001 led to a steep rise in bioterrorism-related government policies and funding, and in state and local preparedness activities, for example, in public health, health care, and the emergency response and public safety communities. The national smallpox vaccination program is but one of many efforts to improve readiness to respond to deliberate releases of biologic agents. The Institute of Medicine (IOM) Committee on Smallpox Vaccination Program Implementation was convened in October 2002 at the request of the Centers for Disease Control and Prevention (CDC), the federal agency charged with implementing the government's policy of providing smallpox vaccine first to public health and health care workers on response teams, then to all interested health care workers and other first responders, and finally to members of the general public who might insist on receiving the vaccine. The committee was charged with providing "advice to the CDC and the program investigators on selected aspects of the smallpox program implementation and evaluation." The committee met six times over 19 months and wrote a series of brief "letter" reports. The Smallpox Vaccination Program: Public Health in an Age of Terrorism constitutes the committee's seventh and final report, and the committee hopes that it will fulfill three purposes: 1) To serve as an archival document that brings together the six reports addressed to Julie Gerberding, director of CDC, and previously released on line and as short, unbound papers; 2) To serve as a historical document that summarizes milestones in the smallpox vaccination program, and; 3) To comment on the achievement of overall goals of the smallpox vaccination program (in accordance with the last item in the charge), including lessons learned from the program.
This electronic version has been made available under a Creative Commons (BY-NC-ND) open access license. This book is available as an open access ebook under a CC-BY-NC-ND licence. Vaccinating Britain shows how the British public has played a central role in the development of vaccination policy since the Second World War. It explores the relationship between the public and public health through five key vaccines – diphtheria, smallpox, poliomyelitis, whooping cough and measles-mumps-rubella (MMR). It reveals that while the British public has embraced vaccination as a safe, effective and cost-efficient form of preventative medicine, demand for vaccination and trust in the authorities that provide it has ebbed and flowed according to historical circumstances. It is the first book to offer a long-term perspective on vaccination across different vaccine types. This history provides context for students and researchers interested in present-day controversies surrounding public health immunisation programmes. Historians of the post-war British welfare state will find valuable insight into changing public attitudes towards institutions of government and vice versa.
This electronic version has been made available under a Creative Commons (BY-NC-ND) open access license. Mass vaccination campaigns are political projects that presume to protect individuals, communities, and societies. Like other pervasive expressions of state power - taxing, policing, conscripting - mass vaccination arouses anxiety in some people but sentiments of civic duty and shared solidarity in others. This collection of essays gives a comparative overview of vaccination at different times, in widely different places and under different types of political regime. Core themes in the chapters include immunisation as an element of state formation; citizens' articulation of seeing (or not seeing) their needs incorporated into public health practice; allegations that donors of development aid have too much influence on third-world health policies; and an ideological shift that regards vaccines more as profitable commodities than as essential tools of public health.
