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Following the attacks of September the 11th and the anthrax letters in October of that same year, the United States government announced its decision to begin smallpox vaccinations for health care workers and eventually the general population of the US. The goal of the government was to better prepare the United States should a smallpox attack occur. They were going to accomplish this goal by vaccinating enough health care workers and first responders to implement a post-event vaccination plan following a large scale outbreak of smallpox. This paper will show that the government has failed to adequately prepare for a post-event scenario following a large scale outbreak of smallpox. The Institute of Medicine's reports on the CDC's pre-event vaccination program were utilized for this paper. The reports conclude that the government of the United States has vaccinated only a fraction of the health care workers and first responders that it had planned to. The initial goal of the CDC was about 500,000 civilian vaccinations in the first month of the program. The end result was less than 40,000 civilian health care workers and first responders vaccinated to date. This leaves the United States grossly unprepared following a large scale outbreak of smallpox. According to reports published by the Institute of Medicine, the lack of a viable threat was a major obstacle in the recruitment of volunteers to participate in the pre-event vaccination program. Several books, including a first hand account by the second-in-charge of the former Soviet Union's biological weapons program, were cited for this paper. The books describe the Soviet's secret biological weapons program that included smallpox. First hand accounts by v AU/ACSC/PARKS/AY08 Russian scientists and American officials detail Russian biological scientist's involvement with nations such as Iran and China, bringing to light the possibility of proliferation of many of the world's deadliest viruses.