Between 5,000 and 6,000 doctors, nurses and other health care workers in Maryland would be vaccinated against the deadly smallpox virus under a plan submitted this week to the U.S. Centers for Disease Control and Prevention.

The plan calls for the vaccination of about 5,000 hospital workers across the state, Arlene Stephenson, acting secretary of the state Department of Health and Mental Hygiene, said yesterday. Smaller hospitals might vaccinate teams of 50 doctors and nurses, she said, while larger ones might vaccinate as many as 250.

About 80 six-person "public health teams" at local health departments and at the state health department also would be vaccinated under the plan.

"It's basically a precaution to protect our citizens should a [smallpox] case occur," Stephenson said. "You need to be able to respond very quickly. In order to do that, you have to do some pre-event planning."

Smallpox, which was declared eradicated worldwide more than two decades ago, is a highly contagious, incurable disease that is easily spread through person-to-person contact. It is fatal about a third of the time.

But the vaccine - which is made from a live virus - poses risks, too, especially for people with suppressed immune systems and skin conditions such as eczema. Experts estimate that about 15 out of every 1 million people vaccinated will develop life-threatening complications, and that one or two of every million will die.

As part of a nationwide effort to prepare for a possible biological attack, every state was required to submit a detailed smallpox response plan to the CDC by Monday. President Bush has yet to announce the administration's plan to vaccinate health care professionals and members of the military - and, possibly, the general public - but is expected to do so soon.

But unless there's a sudden outbreak, it's unlikely vaccinations will begin before Jan. 24, when a provision of the recently passed Homeland Security Act takes effect to protect those who make or give the vaccine from lawsuits if those who are inoculated suffer adverse reactions.

Diane Matuszak, the state's acting deputy secretary for public health, said Maryland officials have gotten no indication from the federal government that the vaccine will be released to them for use before that date.

Stephenson said the vaccinations would be offered on a "purely voluntary" basis at nine sites across the state. People at risk of developing complications would be screened out ahead of time.

"They will start with a larger pool than they actually need so they can screen out those who should not receive it," she said.