Mr. Bush will announce the program Friday and vaccinations will begin in January 2003, senior administration officials told the Associated Press.
The shots will be mandatory for some 500,000 military personnel and recommended for a half-million health care workers who are on smallpox response teams or work in hospitals and emergency rooms, making them more likely to be exposed to the disease.
As of Wednesday night, the CDC had not been informed of the Bush administration’s final decision. Dr. Julie L. Gerberding, the director of the disease control centers, told the New York Times, “We have no confirmation of the policy decision yet.”
In an interview with CNN in Qatar, Defense Secretary Donald Rumsfeld said he had signed off on a plan to give the vaccine to a limited number of troops, starting with those who are designated to respond to domestic emergencies and troops who would be earmarked for deployment to a potential conflict in the Middle East.
For the civilian population, the plan closely tracks recommendations from the administration’s top health officials, rejecting more aggressive proposals that all Americans be offered the vaccine right away.
States have already begun preparing for a vaccination program similar to the one Mr. Bush appears set to announce. Their plans detailing how many people they plan to inoculate during the first stage of vaccinations were due by Monday to the federal government. With all but five plans counted, preliminary numbers show close to a half-million people could be included in the first sweep, Gerberding told the Associated Press on Monday.
The general public will be offered the vaccine on a voluntary basis as soon as large stockpiles are licensed, probably early in 2004, although the government will not encourage people to get them.
“It’s going to be very important for us to make sure there’s ample information for people to make a wise decision,” Mr. Bush said in an interview broadcast Wednesday on ABC.
Federal health officials are preparing a massive public education campaign about both the disease and the vaccine. Polls, including one released Wednesday, show most people would choose to receive the vaccine if given the chance. But health officials fear that many do not adequately understand the risks.
Based on studies from the 1960s, about 15 out of every 1 million people vaccinated for the first time will face life-threatening complications, and one or two will die. Reactions are less common for those being revaccinated. The disease itself historically killed 30 percent of its victims.
Once vaccinations begin, it will be important that certain people not get the vaccine because they face particular risk of side effects. That includes cancer patients, organ transplant recipients, people with HIV, pregnant women and people with a history of eczema.
People who live with others who have these conditions also should not be vaccinated, the studies say, because the live virus used in the vaccine can sometimes escape the inoculation site and infect others.
Routine smallpox vaccinations ended in the United States in 1972. According to the CDC Web site, the vaccine offers protection from smallpox for 3 to 5 years, with decreasing immunity thereafter. The vaccine also provides some protection from the disease if given within seven days of exposure to the virus.