CDC Initial Review of State Smallpox Vaccination Plans Complete

On October 28, 2002, CDC issued post smallpox event planning guidance to the 50 states; the District of Columbia; the commonwealths of Puerto Rico and the Northern Marianas Islands; American Samoa; Guam; the U.S. Virgin Islands; the republics of Palau and the Marshall Islands; the Federated States of Micronesia; and the nation’s three largest municipalities (New York, Chicago and Los Angeles County). To date, all 62 plans have been received and are undergoing review. In addition, CDC issued supplemental guidance on November 22, 2002 that specifically addressed how the state and local health departments intend to vaccinate individuals most likely to respond to a smallpox attack. So far, 49 states and four cities have submitted plans. These plans contain information on the number of people comprising each public health smallpox and health care smallpox response team, information on where vaccines would be administered, the number of health care facilities identified to participate, and the number of clinics needed to support this effort.

“We are extremely pleased and quite impressed with the plans that have been submitted to CDC so far,” says U.S. Department of Health and Human Services Secretary Tommy G. Thompson. “It is obvious the state and local health departments and hospitals have stepped up to the plate under an extremely tight timetable to complete another critical step in our efforts to better protect Americans in the event of an intentional release of smallpox.”

A preliminary review of the plans indicates that close to 450,000 public health and health care personnel may be offered the vaccine when it becomes available. The plan is voluntary and eligible individuals will make their own decision on whether or not to receive the vaccine. Hundreds of clinics around the nation would be set up to deliver the vaccine to those who choose to receive it. In addition, state health officials have identified over 3,300 health care facilities that would participate in the program.

“The development of these plans is fundamental as we prepare the public health system to respond to an intentional release of smallpox. By protecting individuals who would initially be called upon to respond we increase the capacity of the public health system and the nation’s hospitals to control and contain a smallpox outbreak,” says CDC Director Dr. Julie Gerberding. “Although the possibility of an intentional release of smallpox is not quantifiable, the consequences of an outbreak would be great and we must be prepared.”

As expected, no two state plans are identical. The CDC provided states with guidelines, but also the flexibility to design a plan to meet each state’s specific needs.

CDC, working closely with colleagues within the Department of Health and Human Services, state and local health departments, and hospitals, are taking steps to prepare for terrorism emergencies that would impact public health. For more information on these efforts go to

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