1709.1 When Prevention Can Kill: Epilogue
This epilogue accompanies case #1709.0 When Prevention Can Kill: Minnesota and the Smallpox Vaccine Program. In the wake of the terrorist attacks on New York's World Trade Center and the Pentagon in September, 2001, the United States began to take seriously threats which had, heretofore, been generally discounted. Among these was the possibility of "bio-terrorism", or the malicious use of infectious agents to kill on a large scale. Among the potential bio-terror threats that aroused official concern was that of smallpox, one once-epidemic disease that had been eradicated worldwide. The fact that small laboratory stocks of smallpox remained extant, and that most Americans had never had reason to be vaccinated against the illness, raised the possibility that such germs could fall into the wrong hands-and be put to deadly purposes. This case describes the operational and political issues which arise when public health authorities in one state-Minnesota-move forward to implement a new federal policy requiring that a core group of "health workers", who might, in a bio-terror crisis, be called upon to inoculate members of the public at large, themselves receive the smallpox vaccine. The case describes both the misgivings of health officials-cognizant of the fact that the smallpox vaccine itself carried potentially serious risk-the planning and implementation of vaccination, and political complications which arise when law enforcement officials in Minnesota demanded that potential "first responders" be vaccinated, in addition to health officials. The case provides a window into the complexity inherent in protecting the public from non-traditional weapons, as well as a window into the complexity of emergency preparedness in the context of a federal system of government.