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In Reply: Contrary to Dr Nass's assertion, active surveillance was the primary source for the published military data on smallpox vaccine safety.¹ Of 18 myopericarditis cases reported,² only 3 were found using the Vaccine Adverse Event Reporting System. Most were first identified among well-observed military personnel via reports to headquarters or from the Defense Medical Surveillance System.³

The death of a 22-year-old female soldier was reported,¹ but pericarditis had not been diagnosed at that time. At the time of this writing, her death is classified as "unexplained" by the CDC. The Department of Defense is consulting with civilian medical experts to determine if this death was related to smallpox vaccination.

There are considerable differences between the military and civilian vaccinee populations in age and sex mix, underlying health, and access to medical care. Most military myopericarditis cases are classified as "probable," whereas most civilian cases are "suspect."⁴ It is not . . . [Full Text of this Article]

John D. Grabenstein, RPh, PhD; James R. Riddle, DVM, MPH; Mark K. Arness, MD, MT&MH; William Winkenwerder, Jr, MD
Department of Defense
Washington, DC

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