“The King of Terrors” Revisited: The Smallpox Vaccination Campaign and its Lessons for Future Biopreparedness

John Adams referred to smallpox as the “King of Terrors.” McCullough D. , John Adams (New York: Simon and Shuster, 2000): At 141.

Koplow D.A. , Smallpox: The Fight to Eradicate a Global Scourge (Berkeley: University of California Press, 2003): At 10, citing T.B. Macaulay.

McCullough , supra note 1, at 142–43.

Koplow , supra note 2, at 11–13. On Cuitlahuac, see Enriquez J. Tang Yeh C. Martinez R. , “SARS, Smallpox, and Business Unusual,” Harvard Business School Working Paper (draft), July 2003: At 7.

Koplow , supra note 2, at 13–14.

Butterfield L.H. Friedlander M. Kline M. , eds., The Book of Abigail and John: Selected Letters of the Adams Family 1762–1784 (Cambridge, Mass.: Harvard University Press, 1975): At 137.

Koplow , supra note 2, at 18.

Ewald P.W. , Plague Time (New York: Oxford University Press, 2000): At 179.

Id. at 103.

Alexander J.T. , Catherine the Great: Life and Legend (New York: Oxford University Press, 1989): At 147.

Id. at 147–48.

Koplow , supra note 2, at 18.

Butterfield L.H. , ed. Diary and Autobiography of John Adams: Vol. 3 (Cambridge: Harvard University Press: 1961): At 280; McCullough , supra note 1, at 142–44 (on the effects of variolation).

Koplow , supra note 2, at 18–19.

Id. at 19.

Preston R. , “The Demon in the Freezer (New York: Random House, 2002): At 102–03.

For example, President Clinton discussed the issue in his May 1999 commencement address at the Naval Academy in Annapolis, Maryland.

O'Toole T. Mair M. Inglesby T.V. , “Shining Light on ‘Dark Winter,’” Clinical Infectious Diseases 34 (2002): 972–983, available at <http://www.journals.uchicago.edu/CID/journal/issues/v34n7/020165/020165.web.pdf>.

Id. at 12–13.

Nunn's testimony is quoted by The Center for Civilian Biodefense Studies, at <http://www.hopkins-biodefense.org/darkwinter.html> (last visited October 1, 2003).

This phenomenon, known as Multiple Idiopathic Physical Symptoms (MIPS) was the subject of a conference held at Georgetown University on June 12, 2003—under the auspices of the Life Science and Society Initiative and the Imaging Science and Information Systems (ISIS) center. The proceedings of the conference will be published with support from the CDC.

Orenstein W. , Smallpox: Lessons from the Past, Strategies for the Future, Clouded by Uncertainty , presented at Smallpox Preparedness and Adverse Effects Management Working Session, Georgetown University, March 3, 2003 (publication forthcoming).

“Smallpox Fiasco,” Washington Post, July 14, 2003, at A20–21 (editorial). “Are We Ready?,” Washington Post, July 13, 2003, at B06 (editorial); Heil E. , Panel Questions HHS on Low Smallpox Vaccinations, available at <http://www.govexec.com/dailyfed/0703/072403cd2.htm> (July 24, 2003).

President Delivers Remarks on Smallpox , (White House press release), at <http://www.whitehouse.gov/news/releases/2002/12/20021213–7.html> (December 13, 2002).

Maj. Gen. J. Parker, Threat Assessment and Uncertainty, presented at Smallpox Preparedness and Adverse Effects Management Working Session, Georgetown University, March 3, 2003 (publication forthcoming).

At the Georgetown Conference on Smallpox on March 3, 2003, Dr. C. Everett Koop commented on the volumes of information on the smallpox vaccine and its potential side effects, noting the difficulty a layman could potentially have with sorting through the data on the CDC website to find information or to communicate.

Graham B. , Vaccinia Vaccine and the Biology of Adverse Effects Management , presented at Smallpox Preparedness and Adverse Effects Management Working Session, Georgetown University, March 3, 2003 (publication forthcoming).

Connolly C. , “Cardiac Cases Raise New Vaccination Questions,” Washington Post, March 27, 2003, at A12.

Connolly , supra; Connolly C. , “Second Vaccinated Worker Dies of Heart Attack,” Washington Post, March 28, 2003, at A09.; Connolly C. , “Two States Halt Smallpox Shots,” Washington Post, March 29, 2003, at A07.

Miller H.I. , “A Shot in the Dark,” San Francisco Chronicle, March 12, 2003; Connolly C. , “Lawmakers, White House Agree on Smallpox Compensation,” Washington Post, April 11, 2003 at A11.

The vaccine carries the cowpox virus, creating the slim risk that during the incubation period, the virus might infect others.

Rawls J. , A Theory of Justice (Cambridge: Harvard University Press, 1971): At 313, 343.

Gostin L.O. , “Public Health Law In an Age of Terrorism: Rethinking Individual Rights and Common Goods,” Health Affairs, 21, no.6 (2002): At 86, 90–91.

Schneider C.P. Gostin L.O. , “Reining in the King of Terrors” (unpublished editorial submitted to the Washington Post in March of 2003, on file with author (CS); Connolly C. , “Smallpox Campaign Taxing Health Resources,” Washington Post, March 10, 2003 at A04.

Weinstock M. , “Big Shot,” Government Executive, July 15, 2003, at 6, available at <http://www.govexec.com/features/0703/0703s3.htm>.

The Technical Reference Model is available through the Federal Enterprise Architecture Program Management Office, at <http://www.feapmo.gov/feaTrm2.asp> (last visited October 1, 2003).

U.S. Department of Health and Human Services, et al., Information for Health: A Strategy for Building the National Health Information Infrastructure , Report and Recommendations from the National Committee on Vital and Health Statistics, available at <http://ncvhs.hhs.gov/nhiilayo.pdf> (November 15, 2001).