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Someone You Are Close to May Get the Smallpox Vaccine: What You Should Know and Do [Español]

If someone you have close, physical contact with (your spouse, partner or other member of your household) is considering getting the smallpox vaccine, there are some things you should know.

Before Vaccination: What You Should Know

The smallpox vaccine contains a live virus called vaccinia, which is related to smallpox, though milder. The vaccine helps the body develop immunity to smallpox. And while the smallpox vaccine is safe and effective for most who receive it, people with certain health conditions are more likely to have serious reactions to the smallpox vaccine. These people should not be vaccinated and they should not be in close contact (household or similar intimate physical contact) with someone who has been vaccinated.

Careful screening measures are in place to help ensure that people who are more susceptible to serious reactions, or who live with others who are more susceptible to serious reactions, are not vaccinated. As your close contact considers vaccination, it's important that you actively participate in this screening process. Inform your close contact if you have any of the conditions listed below, or even if you have any concerns about any of the conditions listed below.

Health conditions that would mean you should not be in close contact with someone who has been vaccinated are:

• A diagnosis of eczema or atopic dermatitis, past or present
• A weakened immune system, for whatever reason (HIV, cancer and cancer treatment, some autoimmune diseases and some treatments for autoimmune conditions can weaken the immune system)
• A skin condition with breaks in the skin (chickenpox, shingles, burns, severe acne, etc …) or
• Pregnancy

If any of these conditions apply to you, you should not be in close contact with someone who has gotten smallpox vaccine because of the risk it poses to you (or your fetus if you are pregnant).

After Vaccination: What You Should Know

If neither you nor your close contact has any condition that might place you at increased risk from a serious reaction, and that close contact decides to get vaccinated, there are still some things you should keep in mind.

The main concern for people who have close, physical contact with someone who has gotten the vaccine is that the vaccinia virus can be spread from the vaccination site, causing rash (mild to severe), fever, and head and body aches. Vaccinia is spread by touching a vaccination site before it has healed or by touching bandages, clothing, or other material contaminated with live virus from the vaccination site and then touching another part of the body or touching someone else. The vaccination site often becomes itchy, which may lead to scratching, rubbing, or touching the site.

In the past, when vaccinated persons spread vaccinia to other parts of their body, it often was to their eyes or their genitals. Vaccinated persons also can spread vaccinia to other individuals. In the past, this was reported to occur between 20 and 60 times out of 1 million people vaccinated for the first time and often involved children. Most of the time, this took place in situations of close contact, such as happens in a household, or in similar situations involving close physical contact where careful hand hygiene and site care may not be followed.

After Vaccination: Taking Care

People getting the vaccine will receive instructions for special care to minimize the risk of spreading vaccinia by touch, but you also can take precautions to protect yourself. These measures should be followed until the scab that forms at the vaccination site after vaccination falls off on its own (in 2 to 3 weeks).

• Do not touch the vaccine site or any materials that might be contaminated with live virus from the site (such as bandages, towels, clothing, or washcloths used by the person who got the vaccine).
• If you accidentally come in contact with the vaccine site, or something that may be contaminated with live virus, immediately wash with soap and warm water.
• If you share a bed with the vaccinated person, be sure that they are wearing a gauze bandage held in place with first aid adhesive tape over the vaccination site. As an extra precaution, the person who got the vaccine can wear a shirt or pajamas that cover the bandaged vaccine site. If they do not, you may choose to sleep in a separate bed. (When involved in direct patient care, healthcare workers should cover the gauze with a semipermeable dressing as an additional barrier.)
• Keep a separate laundry hamper for items like clothing, towels, or bedding that have come in direct contact with the vaccine site or drainage from the site. Launder these items, using warm water with detergent and/or bleach and wash hands carefully afterwards.
• Remind the person who got the vaccine to follow site care and hand washing instructions. If their hand is contaminated and they touch you, you can contract vaccinia.

For more information, visit www.cdc.gov/smallpox, or call the CDC public response hotline at (888) 246-2675 (English), (888) 246-2857 (Español), or (866) 874-2646 (TTY).

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Last Revised: February 4, 2003

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