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SMALLPOX
FACT SHEET
Smallpox
Vaccination: An Important Decision |
The
smallpox vaccine was used to eradicate smallpox disease from the Earth.
However, supplies of the smallpox virus still exist, and concern that smallpox
might be used as a weapon has led the United States government to prepare
for a fast and effective response to a smallpox outbreak.
Part of this
preparedness effort is the creation of smallpox healthcare teams that
would respond to a smallpox emergency. Members of these teams would investigate,
manage and control a smallpox outbreak. Membership on these teams is voluntary,
but vaccination of team members is required for their own safety and to
ensure that team members cannot transmit smallpox.
Individuals
considering smallpox vaccination should be well informed about smallpox
disease; the vaccine and its side effects—including potentially
life-threatening reactions; and health conditions that indicate an individual
should not be vaccinated as part of this preparedness effort because they
are at increased risk of experiencing adverse reactions to the vaccine.
This fact sheet provides an overview of the information that will be provided
to those offered the vaccine.
Smallpox
Disease
- The deliberate
release of smallpox is now regarded as a possibility.
- Smallpox
is a serious, contagious and potentially deadly disease that can be
prevented through vaccination.
- Vaccination
within 3 days of exposure to smallpox will prevent or significantly
lessen the severity of symptoms in most people. Vaccination 4 to 7 days
after exposure offers some protection from disease or may reduce disease
severity.
The
Smallpox Vaccine
- The vaccine
is safe and effective for most people who receive it. This same vaccine
was used to eradicate naturally occurring smallpox.
- The vaccine
to be used for smallpox response teams is licensed and passes all tests
required by the Food and Drug Administration.
- The smallpox
vaccine provides high-level immunity from smallpox for 3 to 5 years,
with decreasing immunity thereafter.
- Persons
receiving smallpox vaccinations previously (before 1980) should assume
they have little or no immunity to smallpox today and will require a
new vaccination if they wish to be a member of smallpox response team.
- Smallpox
vaccine contains live vaccinia virus to protect against smallpox. The
virus can spread to other parts of the body and to other people. The
vaccine site ought to be cared for carefully for this reason.
- Smallpox
vaccine does not contain smallpox virus and cannot give you smallpox.
- The vaccine
can have side effects ranging from normal, typically mild reactions
to potentially life-threatening reactions causing death (see “Possible
Reactions to the Vaccine” in this fact sheet).
- People
with certain conditions are at greater risk of experiencing serious
reactions and should not get the vaccine unless they have been exposed
to smallpox (see “Who Should Not Get the Vaccine” in this
fact sheet).
- Careful
screening can identify people more likely to have serious reactions
and thus help prevent them.
Possible
Reactions to the Vaccine
- Minor
reactions—including sore arm, fever and body aches—are common.
- Serious
reactions can occur, including a toxic or allergic reaction at the vaccination
site, spread of the vaccinia virus to other parts of the body or to
other individuals, or spread of the vaccinia virus through the blood.
(In the past, these occurred in about 1,000 people for every 1 million
people vaccinated for the first time.)
- Life-threatening
reactions can occur, including inflammation of the brain, ongoing infection
of the skin with tissue destruction, and disfiguring and painful skin
rashes. (In the past, between 14 and 52 people for every 1 million people
vaccinated for the first time experienced these reactions.)
- Based
on past experience, it is estimated that between 1 and 2 people per
every 1 million vaccinated may die from complications of the vaccine.
Site Care
- The
vaccination site must be cared for carefully until the scab that forms
after vaccination falls off on its own (in 2 to 3 weeks).
- Proper
care (including hand washing, covering the site with gauze, wearing
long-sleeved shirts) can decrease the risk of spread of the vaccinia
virus.
- Health
care workers involved in direct patient care need to take additional
measures for site care, such as using semi-permeable dressings.
Who Should Not Receive the Vaccine
Individuals who have any of the following conditions, or live with someone
who does, should NOT receive the smallpox vaccine unless they have been
exposed to the virus:
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Eczema or atopic dermatitis (even if it is not currently active, mild,
or experienced as a child).
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Other skin conditions such as burns, chickenpox, shingles, impetigo,
herpes, severe acne, or psoriasis (Individuals should not get the vaccine
until the condition has completely healed).
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Weakened immune system (for instance, from cancer treatment, an organ
transplant, HIV, or medications such as steroids to treat autoimmune
disorders and other illnesses).
-
Pregnancy or plans to become pregnant within 1 month of vaccination.
In addition, individuals should not receive the smallpox
vaccine if they:
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Are allergic to the vaccine or any of its ingredients.
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Are less than 12 months of age. Also, the Advisory Committee on Immunization
Practices advises against non-emergency smallpox vaccination in those
younger than 18 years of age.
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Are currently breastfeeding.
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Have a moderate or severe short-term illness. (These people should wait
until they recover to get vaccinated.)
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Have been diagnosed by a doctor as having a heart condition with or
without symptoms, including conditions such as previous myocardial infarction
(heart attack), angina (chest pain caused by lack of blood flow to the
heart), congestive heart failure, and cardiomyopathy (heart muscle becomes
inflamed and doesn't work as well as it should), stroke or transient
ischemic attack (a "mini-stroke" that produces stroke-like
symptoms but no lasting damage), chest pain or shortness of breath with
activity (such as walking up stairs), or other heart conditions being
treated by a doctor should not get the vaccine at this time. (Heart
disease may become a temporary exclusion and may change as more information
is gathered.)
- Individuals
who have 3 or more of the following risk factors should not get the
vaccine at this time: high blood pressure diagnosed by a doctor; high
blood cholesterol diagnosed by a doctor; diabetes or high blood sugar
diagnosed by a doctor; a first degree relative (for example, mother,
father, brother or sister) with a heart condition before the age of
50; and/or, currently a cigarette smoker. (These may be temporary exclusions
and may change as more information is gathered.)
Cost
of Treatment of Vaccine Reactions
- Treatments
for the more serious reactions can be very expensive. There is no federal
program to pay these expenses. Workers compensation or health insurance
may cover these expenses. If not, individuals may end up being responsible.
- Individuals
may lose time from work following vaccination because of illness or
because of concern that they could transmit the virus to others. There
is no program in place to cover this. Individuals should check with
their employer to see if the employer or workers compensation would
cover this.
For more
about vaccination, see Smallpox
Vaccine.
CDC public response hotline: |
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English:
(888) 246-2675 |
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Español:
(888) 246-2857 |
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TTY:
(866) 874-2646 |
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Page last reviewed August 5, 2004
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