John Bartlett, MD


July 23, 2003

In This Article


Committee on Smallpox Vaccination Program, Implementation Board on Health Promotion and Disease Prevention, Institute of Medicine. Review of the Centers for Disease Control and Prevention's Smallpox Vaccination Program Implementation: Letter Report #3, 2003. This is a letter from the Institute of Medicine (IOM) dated 5/23/03 to Dr. Julie Gerberding, Director of CDC, which provides advice on implementation of the pre-event smallpox vaccination program. The letter recommends "a pause to evaluate." The reasons for the recommended pause are the following:

  • Safety: It is noted that through 4/29/03, only 34% of vaccinees were included in the Active Surveillance system. It was also noted that cardiac complications were unexpected and that there may be additional adverse effects.

  • Changing circumstances: There is concern that the educational materials need to be updated. For example, the Pre-Vaccination Information Packet has not been updated since 3/31/03.

  • Overall smallpox preparedness: The rationale here is to determine the required level of pre-event vaccination and what personnel should be vaccinated.


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