WASHINGTON, Jan 17: The U.S. government’s top medical advisers on Friday strongly questioned President George W. Bush’s smallpox vaccination plan, siding with labour groups who say it leaves too many questions unanswered.

The plan to vaccinate upwards of 400,000 emergency and medical workers, and eventually millions more, does not address the issue of who pays when someone gets sick from the vaccine, the report said.

Last month Bush announced a plan to vaccinate close to one million health-care workers and members of the military in case of a biological attack using smallpox as a weapon.

Smallpox was eradicated worldwide in 1989 but several countries, including the United States, have stocks of the virus that could be used to make weapons.

The vaccine that wiped out smallpox is an old formula and causes many side effects. It kills between one and two in every million people who receive it, and Americans may be more vulnerable to side effects than in the 1970s when general vaccination ended.

But the Bush administration decided the risk was worth taking in view of the possible threat of biological attack. The Centers for Disease Control and Prevention asked the Institute, which advises the government on matters ranging from vitamin requirements to vaccine safety, to take a look at the plan.

“The smallpox vaccination program has been competently planned by public health authorities, and decades of experience in vaccination programs and in clinical medicine have been brought to bear on this process,” the report said.

But the Institute raised many issues that labor unions and other groups have — that the plan does not say what happens to people who get sick. Not only are the vaccinated workers at risk, but so are people they come into contact with in the first two weeks after being vaccinated.

It urged Congress and the Department of Health and Human Services to take up the issue, perhaps looking for “bold and creative” solutions.

Otherwise, many may refuse to get the vaccine, undermining the plan, the committee warned.

It says the CDC needs to watch the first phase of the vaccine program — the voluntary immunization of health and emergency workers — and analyze what happens there before vaccinating anyone else, the report said.

Many health care workers who get vaccinated could need to take a few days off work because the vaccine can cause flu-like effects. This is also not considered in the plan and can cause problems both for the workers and their employers.

Unions welcomed the report.

“It is wrong for President Bush to ask health care workers to participate in a vaccination program that is not safe,” said Andrew Stern, president of the Service Employees International Union, one of the biggest critics of the plan. He recommended a delay in the program until the concerns raised by the report have been addressed.

The American Federation of State, County and Municipal Employees also called for a delay.—Reuter