By Laura Meckler
The Associated Press

WASHINGTON - The Bush administration plans to recommend emergency room workers and first-response teams take the smallpox vaccine. The shot soon would be available to other health care workers and emergency responders, but states would have a say in which ones it would be recommended for.

The general public eventually would be offered the vaccine but not encouraged to get the shots, administration officials said.

Questions about who should be offered the vaccine, which carries risks including death, and whether to recommend it or just make it available, have occupied federal health officials and the White House for months. Administration officials say a decision from President Bush is expected soon, possibly by next week.

Mr. Bush also is close to approving a plan for vaccinating U.S. military forces against the disease.

Smallpox was wiped out worldwide two decades ago, but experts fear the contagious, often fatal disease could return through an attack by terrorists or a hostile nation. Routine vaccinations ended in the United States in 1972, meaning nearly half of the population is without any protection from the virus. Health officials aren't sure whether those vaccinated decades ago have any level of residual protection.

Under plans not yet final, the vaccine would be offered in stages, beginning with those most likely to encounter a smallpox patient. That includes people on special state response teams, who would investigate suspicious cases of smallpox, and those who work in hospital emergency rooms.

Federal officials believe that this group, expected to number about a half-million, should get the shot, and they plan to recommend it for them, according to two administration officials who spoke on condition of anonymity.

In the second phase of vaccination, the shot would be offered to other health care workers and emergency responders such as police, fire and emergency medical technicians. Federal officials probably will recommend the shot for these roughly 10 million people, too.

Plans are not complete for how the vaccine would be offered to the public, but officials do not plan to recommend it for Americans who have no particular risk of exposure.