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Monday, January 27, 2020  


(WASHINGTON) – "The crush of the current smallpox vaccination activity is taking a large toll on public health agencies," Patrick M. Libbey today told Senators at a hearing on smallpox vaccination. "It cannot be sustained without grave harm to a public health system that has already redoubled its efforts in order to improve the nation’s overall public health preparedness, warned Libbey, executive director of the National Association of County and City Health Officials (NACCHO).

Libbey testified before the Subcommittee on Labor, Health and Human Services, Education, and Related Agencies of the Senate Appropriations Committee.

Libbey told the Subcommittee that redirecting current federal bioterrorism preparedness funding to smallpox halts local public health agencies’ progress in bioterrorism preparedness and leaves the nation increasingly vulnerable to other agents, such as anthrax, ricin, or nuclear materials. He cited a recent Web-based survey conducted by NACCHO to determine how the smallpox vaccination program has affected local public health agencies thus far. More than 58 percent of 718 respondents reported that smallpox work is hurting their other bioterrorism preparedness efforts.

"It is equally alarming to us that more than one-third (35%) of the survey respondents reported that smallpox already is negatively affecting other public health programs," Libbey said. The NACCHO survey found that public health clinics providing such services as childhood and influenza immunizations have been deferred, delayed or canceled due to the demands of smallpox vaccination in 182 jurisdictions. "We are gravely concerned that, if diversion of general public health resources to smallpox vaccination continues and grows, our communities will become more vulnerable to ongoing public health threats such as influenza, childhood diseases, West Nile virus, contaminated drinking water, food-borne illness, and chronic diseases," emphasized Libbey.

"Planning, implementing, and evaluating a national smallpox vaccination program in a way that maximizes effectiveness and minimizes risk to individuals involves many more components than routine immunization programs," Libbey explained. "There is much more to it than lining people up in a mall to get their flu shots." Smallpox vaccination is costing localities from $142 to $220 per person, according to preliminary estimates from four large urban public health agencies.

"We are losing the most important potential of bioterrorism preparedness

funding, which was to help states and localities build the capacities needed to address multiple public health threats," warned Libbey. He strongly urged the Committee to provide state and local health departments and other parties who must bear the costs of implementing the smallpox vaccination program with the funds to fulfill the President’s mandate. To read the complete text of his statement, please visit

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