[ OUR OPINION ]

Reality bites off a piece
of smallpox threat

THE ISSUE Only 181 health care workers have been vaccinated for smallpox, although state officials first estimated 3,000 should be.

THE VAST difference between the 181 medical professionals who have been inoculated against smallpox vs. the 3,000 state health officials initially estimated were needed does not necessarily mean Hawaii is ill-prepared for a bioterrorism attack. Rather, the lower number reflects a more realistic assessment of the potential for a smallpox outbreak than that shaped by the Bush administration as it moved the nation toward war.

However overstated the threat, state health officials are wisely vaccinating health care volunteers whenever they can and stockpiling vaccines in the islands.

Hawaii isn't alone in not meeting its goals. The Bush administration sought to vaccinate 500,000 health care workers nationwide, but so far only about 36,000 volunteers have been inoculated. Some states have been more successful than others. Texas, the president's home state, has vaccinated the most, at 4,100, and Nevada, the least, with just 10.

Officials attribute the low volunteer numbers to apprehension about reactions to the vaccine -- which range from rash and mild fever to blindness and heart inflammation -- as well as the scaling down of the war in Iraq. In addition, the administration lagged in assuring compensation for injury and lost wages to those who received inoculations, signing a bill only this month.

The biggest obstacle, however, is the lack of information forthcoming from the government about the likelihood of a smallpox bioterrorist event. Health care officials are hard-pressed to argue the benefits of inoculation when evidence of the risk remains ambiguous.

State health officials say they believe Hawaii has sufficient medical professionals to handle a bioterror attack using smallpox. They contend vaccinations can be administered after an outbreak because vaccines are on hand and can be effective even as long as four days after exposure. However, the vaccine requires several days to take hold and about seven days to determine if immunization was successful. In addition, people can transmit the disease to others as long as three weeks after inoculation. Further, administering vaccines in the confusion and panic after an attack may not be the best of circumstances.

The goal of terrorism is to stir anxiety and unease, and proper responses to undefined threats are difficult to formulate. While the inability of locating Iraq's weapons of mass destruction, which the administration gave as a prime reason for attacking that country, has increased public skepticism about the veracity of its statements, the recent attacks in Saudi Arabia evince a continuing menace remains despite U.S. efforts.

In that atmosphere, health officials must stay alert and the public prepared. Because of the highly contagious nature of smallpox, just one confirmed case is considered a public health emergency.