Get Rid of Smallpox? Not Yet

Impact

Smallpox isn’t actually gone. The deadly virus is still used for critical health and defense research in government labs to help protect the U.S. against a possible outbreak. Smallpox is one of the fiercest members of the infectious disease family with a historical fatality rate of 30%. Those who do survive the initial phases are often left with scores of unsightly scars covering their bodies. With the World Health Organization now scheduled to vote on whether countries should wipe out their remaining stocks, the issue of keeping the deadly virus has again risen in public debate.

After D.A. Henderson’s historic campaign to rid the world of the disease in the 1970s, WHO declared smallpox eradicated in 1980. But both the U.S. and U.S.S.R. maintained small amounts of the virus for various purposes. In 1994 it was revealed that the former Soviet Union had weaponized the virus for use in a potential bioattack. To this day, the U.S. still maintains its collections of smallpox in high security laboratories. There now is a growing call for the government to eliminate these stocks.

But destroying the smallpox stocks is a risk we cannot take. Maintaining the strains is vital to testing new vaccine candidates in the effort to improve and perfect our ability to protect against the virus. If we want a better smallpox vaccine, we have to be sure it works against the disease itself. Destroying the strains we have in our labs would render the research to achieve this goal impossible.

Opponents of this rationale argue that there is no need for vaccine improvement because the current vaccines stockpiled by the U.S. are effective. 

While it would be a humanitarian victory to declare the world free from the virus, this argument fails to look at some key facts. First, the current vaccines kept in the U.S. Strategic National Stockpile (SNS) are abundant but are not ideally effective in individuals with weakened immune systems. In some cases, vaccination with these products can cause serious and life-threatening internal reactions. In fact, this unpredictability is the reason why in 2007 Health and Human Services began the procurement process for a new version of a smallpox vaccine that uses non-replicating vaccinia virus (the active element of a typical smallpox vaccine).

Furthermore, the global population is more vulnerable to a potential smallpox outbreak now than it has been for some time. According to the Center for Biosecurity at the University of Pittsburgh Medical Center, “[S]ince routine smallpox immunization ceased in the United States in 1972 and in all other countries by 1983, the global population is extremely vulnerable to the disease. Much of the world’s population has never been vaccinated or was vaccinated so long ago that immunity to smallpox has waned.”

Considering that we have room to improve our vaccine arsenal so that all Americans are protected in the event of a smallpox bioattack or outbreak, and that our population is now more needful of an effective vaccine than it has been in the past, destroying the smallpox stocks on humanitarian grounds is a premature step that subjects our country to unnecessary health risks.

Photo CreditCDC/Fred Murphy, Public Health Image Library