Smallpox

In May 1980, WHO declared the global eradication of smallpox. Currently, there is no evidence of smallpox transmission anywhere in the world. The last reported case of endemic smallpox occurred in Somalia in October 1977, and the last reported case of laboratory-acquired smallpox occurred in the United Kingdom in 1978. WHO amended the International Health Regulations on January 1, 1982, deleting smallpox from the diseases subject to the regulations.

Smallpox vaccination should not be given for international travel. The risk from smallpox vaccination, although very small, now exceeds the risk of smallpox; consequently, smallpox vaccination of civilians is currently indicated only for laboratory workers directly involved with smallpox or closely related orthopox viruses (e.g., monkeypox, vaccinia, and others) and public health personnel that may be involved in the first response to an intentional release of smallpox virus. Health-care workers whose contact with these viruses is limited to contaminated materials (e.g., dressings) are at a lower risk of inadvertent infection than laboratory workers, but may be considered for vaccination. In response to a confirmed smallpox outbreak within the United States, rapid voluntary vaccination of a large population may be required to 1) supplement priority surveillance and containment control strategies in areas with smallpox cases, 2) reduce the population at risk for additional intentional releases of smallpox virus if the probability of such occurrences is considered substantial, or 3) address heightened public or political concerns regarding access to voluntary vaccination. Large-scale voluntary smallpox vaccination would be considered part of an overall national vaccination strategy and would be initiated following the approval of the Secretary of Health and Human Services.

Misuse of Smallpox Vaccine

Smallpox vaccine should never be used therapeutically. There is no evidence that vaccination has therapeutic value in the treatment of recurrent herpes simplex infection, warts, or any other disease.

— Rafael Harpaz