Note too, that strict quarantine is difficult to effect. Yet the CDC believes they can isolate areas of exposure and control the spread of an virulent airborne virus by ring vaccination. They even have told the Senate (according to Senator Maria Cantwell) that is how smallpox was eradicated in the Third World! They are completely ignoring the pertinent fact that the U.S. population is not a part of the Third World, but is in fact the most mobile society in the world.
But by golly, what a relief to know that the doctor who will sign my death certificate was vaccinated and safe(sarcasm).
What the CDC has recommended will not work.
There is a definite measurable risk from Smallpox vaccination. The risk of death is currently 1 per million for primary vaccinees and 0.1 per million for re-vaccinees. For children under 1 year of age the risk of death is 5 per million.
Among primary vaccinees, the combined incidence of postvaccinal encephalitis and vaccinia necrosum is 3.8 per million in persons of all ages. In re-vaccinees these two complications occur at a rate of 0.7 per million. Severe complications of vaccination occur in people who are immunodeficient, immunosuppressed, haematological, suffering other malignancies or pregnant. Source of my information: 'Jawetz, Melnick & Adelberg's Medical Microbiology' 20th Edition. Editors: G. F. Brooks, J. S. Butel and L. N. Ornston. Published in 1995.
Therefore, I estimate around 750 serious illnesses (some will cause permanent disabilities or brain damage) and about 170 deaths due to Smallpox vaccination of the applicable portion of the entire population. Now, obviously, that is a much lower number of deaths than might occur if Smallpox was actually used in an attack. However, we would look like idiots if we vaccinated everyone and lost that number of people, and then all the worries about Smallpox being possessed by al-Qaeda turned out to be media hype.
You are right that impressive quarantine methods would be needed to control the spread of a smallpox epidemic after an attack. It would be a very difficult and desperate situation to seal off a major city like New York, or more than one city, and confine people to their homes until they are vaccinated. However, if we vaccinated everyone just in case there is a Smallpox attack, which never materialised, then the hundreds of serious illnesses and deaths that would result would be a further victory for the terrorists. The decision whether or not to perform mass vaccination in the current climate is a dilemma.
I think that Smallpox vaccination should be available to those who want it and that if evidence of a biological attack in preparation comes to light then a mass vaccination program should be begun. However, you can protect yourself from the Smallpox epidemic subsequent to a biological attack by laying up supplies of food and other essentials and getting an appropriate gas mask and coveralls to use when you have to leave your home. Also turn off shared air conditioning systems if you live in an apartment building. These precautions would protect you from exposure to the virus until you are vaccinated and have developed immunity.