Washington ? A scientific panel recommended against smallpox vaccinations for the general public Tuesday because of concerns about side effects — both for those receiving the shots and others in contact with them.

The focus of smallpox preparedness should move away from the number of people vaccinated to concentrate on who needs to be prepared for a possible smallpox attack by terrorists and how communities should respond, the panel said.

The efforts of the Centers for Disease Control and Prevention to ready the nation for bioterrorism won praise from Brian Strom of the University of Pennsylvania, chairman of the Institute of Medicine committee that prepared the report.

“That said, we need to begin to shift the focus away from vaccination toward preparedness in general,” Strom said in a telephone briefing on the new report.

The Bush administration launched a program last year requiring smallpox vaccination for about 500,000 military personnel and offering a voluntary program to immunize several million medical and emergency personnel who would be in immediate danger in a biological attack.

The civilian program has been lagging, however, with 38,004 people vaccinated as of July 25. Many health care workers have resisted getting the shots out of concern over side effects.

That concern was expressed by the committee in urging that the vaccine not be offered to the general public except in clinical trials because it can cause illness in some people.

Someone might be willing to take the risk of vaccination to counter the unlikely event there would be a smallpox attack, the unlikely event it would be in their neighborhood and the unlikely event CDC would be unable to protect them, Strom said.

“But the problem with the smallpox vaccine is it’s a live virus, so when you take on that risk you are taking it on not only for yourself, but for the people around you and those you come in contact with,” who haven’t had the opportunity to say if they want to take the risk, Strom said.