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Discontinuance of Routine Smallpox Vaccination

Reuben Tizes, MD
JAMA. 1972;219(7):908-909. doi:10.1001/jama.1972.03190330066019.
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To the Editor.—  A recent EDITORIAL (218:876, 1971) endorsed recommendations to discontinue routine smallpox immunizations and to substitute selective vaccinations for those at higher risk, such as travelers to countries reporting smallpox, and personnel in health services.The main rationale for this recommendation is that the risk of complications from vaccination is higher than the probability of contracting the disease. Is the probability of contracting the disease calculated with due consideration to the immunity status that now exists in the United States? We are told that only half of the United States population is fully or partially protected. In geographical location, which half? Are metropolitan areas better immunized than rural areas? what is the risk of contracting the disease, if the level of immunity of our population is zero or near zero, as endorsed by the aboveprescribed recommendations? What would be the risk from primary vaccination if this immunization were


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