Federal officials debate whether to recommend, or simply offer vaccine.

2002 NOV 13 - (NewsRx.com & NewsRx.net) -- It's one thing to offer a risky, possibly deadly, smallpox vaccine. It's another to urge people to take it.

U.S. officials planning for smallpox vaccinations are still debating this key issue: should they advise people to get the shot, or just make it available and let everyone decide for themselves?

No matter what, a massive education campaign will be needed once the shots are available to the public, said Dr. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention. She said that officials plan to deliver detailed information directly to doctors, who can advise their patients. They are also planning information aimed directly at the public.

But she and other top health officials also want to offer clear recommendations. They say that advice could change as they learn more about reactions to the vaccine and as the threat of a bioterror attack on the United States goes up or down, but the government ought to be clear.

"It is difficult for people to make a decision without specific guidance," Gerberding said.

But that's not easy. What happens when people are injured - or killed - by the vaccine? Does the government carry extra legal liability if federal officials have recommended it?

The vaccine itself is risky. Based on studies from the 1960s, experts estimate that 15 out of every million people vaccinated for the first time will face life-threatening complications, and 1-2 will die. Reactions are less common for those being revaccinated.