The smallpox virus may not come to the United States in the form of a bomb, but in the form of an anonymous person positioned in the right place at the right time. From one person strategically placed, many people can be infected; and in the 7-17 days for the symptoms of smallpox to appear, those persons can expose many others. This is one reason why officers of the Orange County Sheriff's Office were vaccinated for smallpox even before President Bush announced his smallpox vaccination plan. This plan states that law enforcement and emergency service workers are to be vaccinated in Phase II of the vaccination effort. Although this Phase II mandate is slated to begin on March 1, 2003, there may be a delay due to concerns of medical and labor groups. One of the primary fears about receiving the smallpox vaccine is the adverse reaction that may occur. Serious, but not life-threatening reactions can occur in 1,000 out of 1 million people who receive the vaccine for the first time. On rare occasions, a life-threatening reaction can occur. Members of the Orange County Sheriff's Office have already received the smallpox vaccination through a special project conducted by Mid-Florida Biologicals Inc., in which vaccinia immune globulin (VIG) was used to help people with certain serious reactions to the vaccine. In order to participate in the Mid-Florida Biologicals program, officers, as well as the general public, had to pass a prescreening process that included a complete physical, blood tests, family history, and medical history. Only those who were previously vaccinated, either through the military or as a child, could participate in the program. Once vaccinated, participants were required to donate plasma for a minimum of 4 weeks. This plasma was then used to create more VIG. Two cost issues associated with any smallpox vaccination program are who will pay first responders for time lost on the job due to complications from the vaccine and who will cover liability issues related to citizens adversely affected due to contact with a vaccinated, yet contagious, first responder. Currently, there is no Federal assistance available for the medical costs associated with side effects from the smallpox vaccine. Still, smallpox vaccination is a sound policy, because a widespread vaccination program will reduce the attractiveness of attempting to perpetrate a smallpox epidemic. Another reason to get the vaccination now is that there is time to conduct a proper prescreening process.