4 Nations Thought To Possess Smallpox

Bush administration officials with central roles in smallpox policy said the government-commissioned Advisory Committee on Immunization Practices was unequipped for its ostensible role of balancing the risks of vaccination against the risks of a smallpox attack. The committee recommended against a broad vaccination campaign, but many members said they would change their views if they knew a rogue nation possessed the virus.

"They give the scientific assessment of what the risks of vaccination are," a senior administration official said. "They do not have the same amount of information that is circulated around this issue here."

Those who disclosed the intelligence assessments described above, speaking on condition of anonymity, were not authorized by the White House to do so. Those assigned to speak for the administration's views, who also declined to be identified, would not discuss intelligence reports. They hewed to their public position, as one of them put it, that "there is a concern with regard to North Korea and Iraq that they may have smallpox."

U.S. allies' smallpox fears come in part from U.S. reports and -- especially in Jordan -- from independent intelligence on the Iraqi threat. In an interview, Kuwaiti ambassador Salem Abdullah Jaber Sabah acknowledged that his government asked for vaccine last summer "in readiness for any eventuality."

Two U.S. officials called the requests unlikely to be granted. The scarcity of vaccine, and likely repercussions in domestic and coalition politics, permit Bush to do no more, they said, than offer assurances of help if Iraq's neighbors suffer an outbreak.

Cheney, who confronted biological threats as defense secretary years ago, was energized about smallpox by a videotape and briefing shortly after Sept. 11, 2001. In a war game called Dark Winter, former senator Sam Nunn played a president who failed to contain a fictional smallpox outbreak that began in Oklahoma City. It spread in less than two weeks to 25 states and 15 countries overseas, inflicting "massive civilian casualties."

"It's a dramatic briefing," Cheney's chief of staff, I. Lewis Libby, recalled, "but we were well on this road already." Libby said Cheney favors "a forward-leaning position on protecting Americans from this threat," but declined to describe his advice to the president.

At Health and Human Services, officials said, Thompson has been influenced by doubts at the Centers for Disease Control and Prevention.

"If you look at the vice president's office, they're thinking strategic, not public health," said one debate participant. He cited the swine flu debacle of 1976, when President Gerald Ford had to abandon plans for universal inoculation after people starting dying of the vaccine and others developed Guillain-Barre syndrome, a rare and occasionally fatal paralysis. "If something bad happens, the public is not going to be blaming Dick Cheney, they're going to be blaming Tommy Thompson. And the fact is they're going to be blaming the president. That's why the political people are weighing in, and that's why the decision is still sitting on his desk."

Staff researcher Lucy Shackelford contributed to this report.