Yet another decision: To vaccinate or not?

Decisions, decisions. Now President Bush has left each of us with a really serious one: whether to be vaccinated for smallpox.

This decision could become a matter of life or death. Although the disease had been declared eradicated globally by 1980, Bush worries about disastrous consequences of a bioterrorist attack.

If you were to catch smallpox, your chances of dying from it are about three in 10. Vaccination within about four days of exposure, on the other hand, is about 95 percent effective — but there are important risks of side-effects. Centers for Disease Control experts have estimated that 52 out of every 1 million people vaccinated for the first time will face life-threatening complications, and one or two will die.

Before you get in a stew about deciding whether or not to get vaccinated, however, consider that most of us won't even be offered the opportunity until sometime in 2004. The president wants military personnel to begin getting vaccinations, then emergency medical workers and response teams.

Sufficient stockpiles of the vaccine won't be available for a year or more, and by that time, your family doctor will be up to speed on whether vaccination is right for you.

In general, those who should not be vaccinated include people with compromised immune systems, pregnant women, infants, people with a history of eczema and people who live with those who have these conditions.

Do adults who were vaccinated in their childhood need a new vaccination? That's another judgment call. The effectiveness of a vaccination begins to wear off after three to five years, and it's been 30 years since that last ones were given. The only way to feel sure is to be revaccinated.