Jennifer Lee Carrell The Speckled Monster

To Vaccinate or Not to Vaccinate?

THE ODDS
· The modern smallpox vaccine kills about 1 or 2 in a million people. It will also seriously sicken about 20 more people per million, leaving some of them permanently scarred, blind, or brain damaged.

· While these are almost miraculously better odds than either variolation (1 in 100) or the disease itself (as many as 1 in 3), they are still sobering, and rank the smallpox vaccine as one of our most dangerous.

THE ERADICATION
· Under normal conditions, the smallpox virus cannot live long outside a human body.

· By vaccinating every human being within reach of the virus, an army of hundreds of thousands of health workers from all over the world eventually wiped out the virus's habitat. The last known case was in Somalia, in 1977. In 1980, the World Health Organization declared that smallpox had finally been wiped out.

· Smallpox remains the only disease that we have eradicated from nature.

· Small amounts of the virus survive in deep-freeze in secure labs in the United States and Russia. There is evidence, however, that the USSR spent many years weaponizing the virus, that and Russia cannot now account for all of its stock.

THE ETHICAL DILEMMA
· In a world with smallpox on the loose, the decision to use the vaccine is a no-brainer: in order to save millions, people have proved willing to sacrifice a very small number of lives.

· In a world without smallpox, the sacrifice of 1-2 lives per million becomes pointless and unethical. As a result, the United States phased out universal vaccination in the early 1970s. (The last outbreak of smallpox in the United States was in 1949, in rural Texas.) It was not given out widely again until 2002, when concerns about smallpox as a bioterror weaponconvinced the U.S. military to vaccinate troops possibly in harm's way.

· What do you do in a world where smallpox is a maybe? How much of a maybe makes the odds of vaccination worthwhile?