Despite the underwhelming response to the federal government's initiative to inoculate health care workers against smallpox, the Bush administration has indicated that the program will continue and that it could be expanded to include other health care providers, emergency service workers, and others deemed essential for continuity of government. We discuss the reasons for the program's failure to date, outline recent advisories questioning the extent of the vaccination effort, and suggest suspension of further vaccination efforts until certain questions and issues are resolved.