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Association of American Physicians and Surgeons, Inc.
A Voice for Private Physicians Since 1943
Omnia pro aegroto

December 13, 2002

For Immediate Release:

Kathryn Serkes
[email protected]


Washington-- The Association of American Physicians and Surgeons (AAPS) supports plans coming from the White House to make smallpox vaccinations available to the public in advance of an attack or outbreak on a voluntary basis, but urges the President to speed up the timetable.

“We applaud the President’s recognition that advance, voluntary, immunizations is the right decision,” said Jane M. Orient, M.D., Executive Director of AAPS. “But it could be a fatal error to wait until 2004 to make the vaccine available to the general public.”

Dr. Orient also urged caution before mandating the vaccine for all military personnel. “We hope that lessons have been learned from the anthrax vaccine debacle,” she said.

In September, AAPS released a five-step plan smallpox defense plan and urged President Bush to make the vaccine available to the public. In a letter sent to President Bush , Dr. Orient summarized the concerns in the plan, and wrote:

“Thank you for considering our proposal to make smallpox vaccine available to anyone who wants it in advance of an attack or outbreak. We respectfully urge you to implement this immediately, as any delay could cost thousands of lives in the event of an outbreak.

“The plan announced by the CDC to withhold smallpox vaccine until after an outbreak is fatally flawed, and would most likely lead to chaos and thousands of preventable deaths.

“They claim the vaccine is too dangerous for the general public. But children are routinely required to take vaccines against diseases much less serious than smallpox despite comparable side effects. For example, statistical projections estimate the number of deaths associated with administration of 300 million does of the smallpox vaccine would be 350 deaths. And yet there were 440 deaths associated with only 20 million doses of hepatitis b vaccine in the VAERS data base as of 1998.

“The CDC plan is overly optimistic. Their ring immunization plan is outdated in an age of bio-terrorism. In the days when this was effectively used, an outbreak consisted of a few cases in a population that had a high degree of immunity to begin with. Today, the entire U.S. population is susceptible. And an attack could cause thousands of simultaneous cases in many different areas.

“...Prudent medicine as well as public policy tells us the logical alternative is to make immunizations available, with full disclosure and informed consent, to those who want them. This will allow much more effective screening of those who are at a high risk of complications from the vaccine, and allow people who are more likely to be exposed to voluntarily be inoculated....”

The letter then goes on to outline the medical argument for advance inoculations, such as:

  • The vaccine could not be administered quickly enough to be effective enough post-attack;
  • Protection is needed for about 2 weeks following inoculation, impossible during emergency mass inoculations;
  • Newly immunized medical personnel could infect others, and
  • Immunized volunteers are needed now to produce medicines for others.

The letter concludes: “Mr. President, AAPS has been very vocal in its opposition to mandatory vaccines, and we don’t make these recommendations lightly. But we fear the alternative will be forced immunizations in the face of mass exposure. The potential loss of life is unimaginable. Please allow voluntary screening and vaccination now.”

AAPS is a non-partisan professional association of physicians in all specialties, dedicated since 1943 to the protection of the patient-physician relationship. Dr. Orient, a board-certified internist, is Clinical Lecturer at the University of Arizona College of Medicine. She also serves as Executive Director of Doctors for Disaster Preparedness.