Henry I. Miller of the ACSH argues that the risks of widespread smallpox vaccination outweigh the benefits:

In summary, given the difficulty of estimating the risks and benefits of vaccinating against a non-existent disease using a vaccine that carries known, serious, sometimes-lethal side effects, one must agree with the conclusion of Dr. David Busch, head of infectious diseases at California Pacific Medical Center in San Francisco: "It's inappropriate" to vaccinate the entire country for a disease whose threat is only theoretical, and immunization should only be given "as needed, not as desired."