Contents

• THE NATIONAL ACADEMIES
• COMMITTEE FOR A FORUM ON SMALLPOX: THE SCIENTIFIC BASIS FOR VACCINATION POLICY OPTIONS
• INDEPENDENT REPORT REVIEWERS
• INTRODUCTION
• OPENING REMARKS
• SCIENTIFIC BACKGROUND ON SMALLPOX AND SMALLPOX VACCINATION
  • Smallpox Disease
  • Smallpox Control Strategies and Vaccine Availability
  • Smallpox Vaccination: Efficacy, Availability, Duration of Immunity, and Timing
  • Smallpox Vaccination Safety
• CDC-ACIP SMALLPOX VACCINATION POLICY REVIEW
  • CDC's Draft Policy Options
  • Summary of Regional Meetings
• THE MODELING BASIS FOR VACCINATION POLICY OPTIONS
  • Model 1
  • Model 2
  • Model 3
  • Soviet Outbreak of Smallpox
• LESSONS LEARNED FROM RAPID MOBILIZATION FOR ANTHRAX MASS PROPHYLAXIS: IMPLICATIONS FOR SMALLPOX
  • District of Columbia
  • Arlington County, Virginia
  • Maryland
• EMERGENCY RESPONDERS
  • Emergency Medical Technicians
  • Fire Chiefs
  • Emergency Services
• HEALTH CARE PROVIDERS
  • Nurses
  • Emergency Room Physicians
  • Family Physicians
  • Pediatricians
  • Hospital Workers
  • Hospital Systems
  • Special Populations
• ETHICAL, LEGAL, AND SOCIAL ISSUES
  • Ethical Considerations
  • Indemnification for Adverse Events
  • Communication
  • Risk Communication
• PUBLIC HEALTH RISKS AND BENEFITS
  • Perspective 1
  • Perspective 2
  • Perspective 3
  • Perspective 4
• PUBLIC COMMENTS AND DISCUSSION
  • Use of Scarce Public Health Resources and Insuring Dual Use Approaches
  • Vaccine Development and Approval
  • International Considerations
  • Uncertainties
  • Communication and Education
• EPILOGUE
  • Draft Supplemental Recommendations of the ACIP Use of Smallpox (Vaccinia) Vaccine, June 2002
  • Pre-Release Vaccination of the General Population
  • Pre-Release Vaccination of Selected Groups to Enhance Smallpox Response Readiness

This study was supported by the Centers for Disease Control and Prevention. The views presented in this report are those of the Institute of Medicine Committee for a Forum on Smallpox: The Scientific Basis for Vaccination Policy Options and are not necessarily those of the funding agencies.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.