Offline: The lessons of smallpox eradication for COVID-19

The announcement last week that Rochelle Walensky is President-elect Joe Biden's choice to lead the much-eroded Centers for Disease Control and Prevention was universally welcomed by the US medical community. A respected clinician and scientist, as well as a skilled communicator, she has every prospect of restoring credibility and leadership to the nation's foremost public health agency. Walensky recently co-authored an important paper in Health Affairs, which examined the future determinants of a successful COVID-19 vaccination campaign. Her message was sobering. While the present obsession with vaccine efficacy might be understandable, there are likely to be more important influences on future immunisation programmes-vaccine manufacturing capacity, distribution systems and infrastructure, pace of imple-mentation, coverage, health messaging, and continued adoption of non-pharmaceutical interventions. Those old enough to remember the story of smallpox eradication will not have been surprised by Walensky's conclusions. What is surprising is that we are having to relearn those lessons all over again. D A Henderson led WHO's campaign against smallpox. As we look ahead to the implementation of a worldwide vaccination programme to control the spread of SARS-CoV-2, Henderson's messages deserve revisiting.