Smallpox Vaccine

What is smallpox?

Smallpox is a very serious disease caused by the variola virus (germ). People who have this disease develop fever with a skin rash and blisters that spread all over the body. Smallpox is easily spread from person to person and killed many people in past centuries. Smallpox was wiped out all over the world by 1980 through the use of vaccines. This means that at present no person anywhere in the world has this disease.

What is the smallpox vaccine?

• Vaccines help decrease your risk of infection from certain germs. They work by causing your body to make antibodies against these germs. Antibodies are special cells in your blood that protect your body and fight infection. After the vaccine is given, these antibodies remember the germs. Once you are exposed to these types of germs, your body quickly sees them. The antibodies become active and your body is better able to fight the germs.
  
  
• The smallpox vaccine is made from a live virus called vaccinia. This virus is also a pox-type virus, like the variola virus, but does not cause smallpox. This vaccine also helps protect you from other types of pox viruses. These include monkeypox and cowpox. The vaccine may protect you for 3 to 5 years after the first dose becomes effective (within 10 days of getting it). Your body has decreased protection as the years pass. Protection from the disease can last longer if you get vaccinated again later.

Who should get the smallpox vaccine?

Because smallpox has already been wiped out, the vaccine is no longer part of routine (usual) vaccinations. At this time, the smallpox vaccine is not available to the general public. It is only given to certain people, including those who would take action in case of a smallpox outbreak. Any of these people who where vaccinated for smallpox 10 or more years ago need to be revaccinated. These people take part in the plan made to prepare for a possible smallpox attack (germ warfare). The smallpox vaccine is given to the following people:

• Caregivers who may treat or be in close contact with those who could have smallpox
  
  
• Laboratory workers who handle the smallpox virus or other pox-type viruses
  
  
• Military and other staff members who may be sent to areas with smallpox threat

How is the smallpox vaccine given?

Unlike other vaccines, the smallpox vaccine is not given as a shot. It is given using a special needle that has been dipped into the vaccine solution. The needle pricks the skin on your upper arm and leaves a droplet of the vaccine when it is removed. Pricking is done a number of times over a few seconds. This causes a sore spot and small blood droplets to form.

What happens after I receive a smallpox vaccine?

• Area where the vaccine is given: In 2 to 5 days, a small bump forms on the area where the vaccine was given. The bump becomes filled with fluid and pus, and reaches its biggest size in 8 to 10 days. Within 14 to 21 days after vaccination, the bump dries up and forms a scab. The scab then falls off after 3 to 4 weeks and leaves a scar.
  
  
• Normal, mild reactions: You may have any of the following reactions after getting the vaccine:
  
  
  • You may have itching and redness around the vaccine area.
    
    
  • You may have enlarged lymph nodes (glands) in your armpits.
    
    
  • You may have a fever.
    
    
  • Your arm may be sore and swollen where the vaccine was given. Swelling and pain of the vaccinated area may happen in 3 to 10 days after you get the vaccine. These problems may not go away for 2 to 4 weeks.
    
    
  • Some people may feel bad enough to miss work, school, or certain activities. Some may have trouble sleeping.

What should I do after I get vaccinated?

After you get the vaccine and before the scab falls off, the vaccine virus can be spread. Contact with the vaccinated area may easily spread the virus to other parts of your body. You may also spread the virus to other people. This can happen when you touch the vaccinated area and then touch another part of your body or someone else. The virus may also spread if you touch things that have touched the vaccinated area. These things include bandages, sheets, clothes, and towels.

• After you get the vaccine, it is important to take care of the vaccinated area. The following may help prevent spread of the virus:
  
  
  • Do not scratch or touch the vaccinated area on your arm. Do not touch things that have touched that area.
    
    
  • Do not towel dry the area where the vaccine was given. Cover the area with a waterproof bandage when bathing.
    
    
  • Place a bandage over the vaccinated area. Wear a shirt with sleeves long enough to cover the vaccinated area.
    
    
  • Wash clothes, beddings, or other cloth materials that have touched the vaccinated area. Use water and a germ-killing solution to clean these items.
    
    
  • Wash your hands with soap and water right away if you have touched the vaccinated area.
  
  

Who should not get the smallpox vaccine?

People who are at a higher risk of having bad effects from the smallpox vaccine should not get it. People who are in close contact with others who are at risk of having bad effects should also not get the vaccine. This is true unless there is a smallpox outbreak and you have been exposed to the virus. The following conditions increase the risk of having bad effects with the smallpox vaccine:

• Allergy: People who have an allergy to the vaccine or certain antibiotic medicines have a higher risk of bad effects. The antibiotics include polymyxin B, streptomycin, neomycin, and chlortetracyclin.
  
  
• Young or old age: Children younger than 12 months of age should not receive the vaccine. You may still get a vaccine if you have a child younger than 12 months of age. Also, it is not recommended for anyone under 18 years of age or older than 65 years of age, except in emergency situations.
  
  
• Heart and related conditions: A heart condition may put you at higher risk for heart problems after you get the vaccine. You may still get vaccinated if you have frequent contact with someone who has a heart condition. Heart conditions include heart attack, angina, congestive heart failure, cardiomyopathy, stroke or mini-stroke, or chest pain with activity. It also includes other heart conditions being treated by your caregiver. You should also not get the vaccine if you have 3 or more of the following:
  
  
  • You have a close family member (parent or sibling) who got a heart condition before the age of 50.
    
    
  • You have diabetes or high blood sugar as checked by your caregiver.
    
    
  • You have high blood pressure as checked by your caregiver.
    
    
  • You have high blood cholesterol (fat) as checked by your caregiver.
    
    
  • You are a smoker at present.
  
  
• Skin conditions: Skin conditions, such as eczema or atopic dermatitis, put you at higher risk for bad effects with the vaccine.
  
  
• Weak immune system: People with weak immune systems have a higher risk of bad effects. Your immune system may be weakened by HIV, recent antibiotic use, and certain other medicines. These medicines include steroids, chemotherapy, or anti-rejection medicines taken after an organ transplant.
  
  
• Pregnancy or Breastfeeding: Women who are pregnant or breastfeeding should not receive the vaccine. Your unborn baby is at risk of infection if you get the vaccine while you are pregnant. Also, any person who has household contact with a pregnant woman should not receive the vaccine.
  
  
• Other conditions: People with eye diseases or other conditions that use steroid eye drops as treatment should not receive the vaccine. These people should wait until they are not using the medicine anymore.

What are the risks of getting the smallpox vaccine?

As with any medicine, this vaccine has some risks and may cause side effects. Side effects include redness, rashes, fever, and swelling at the arm site or in the armpit. There is a risk that you could spread the virus in the vaccine to other people by accident. You may also get an allergic reaction to the vaccine and have trouble breathing. The area of the vaccine can get infected with bacteria (germs). More serious reactions include infection by the vaccine virus in other areas of your body. These areas include your eyes, heart, and brain. Your eyes or brain may get long-term damage if this happens. Some of these infections can be life-threatening.

How are bad reactions to the smallpox vaccine treated?

There are no medicines approved to treat bad reactions to the smallpox vaccine. Vaccinia immune globulin (VIG) may help with certain reactions. An antiviral medicine may also be used.

What are the signs and symptoms of a serious reaction to the smallpox vaccine?

• Serious reactions: Serious reactions usually happen to people who are given the smallpox vaccine for the first time.
  
  
  • You may have an allergic reaction. This may appear as hives that have spread all over the body. Hives are red, itchy bumps with burning feeling on the skin.
    
    
  • You may get a red rash or sores in an area other than the vaccinated area. This often occurs with spread of the virus from the vaccinated area. The genitals, face, and eyes are common areas infected. Infection of the eyes with the vaccinia virus may lead to problems with your sight or blindness.
    
    
  • You may have rash or sores over your body. This may happen when the virus enters the blood.
  
  
• Very serious reactions:
  
  
  • Your skin and the tissues under the vaccinated area may be damaged and die.
    
    
  • People with a skin condition, such as eczema or atopic dermatitis, may get rashes.
    
    
  • Your brain may swell.

When should I contact my caregiver?

• Your wound from the vaccine is getting larger or not healing.
  
  
• You are concerned that the virus from your vaccine has spread to another part of your body.
  
  
• You have a bad headache or a fever that does not go away.

When should I seek immediate help?

• You have chest pain or convulsions or you pass out.
  
  
• You have a high fever or shaking chills.
  
  
• You have hives or rashes that have spread all over your body. Hives are red, itchy bumps with burning feeling on the skin.
  
  
• Your face, mouth, or throat are swollen.
  
  
• You have trouble thinking clearly or changes in behavior.
  
  
• You feel weak, dizzy, or have a fast heartbeat.
  
  
• You are wheezing or have trouble breathing.

Where can I get more information about the smallpox vaccine?

• • Centers for Disease Control and Prevention
    1600 Clifton Road
    Atlanta , GA 30333
    Phone: 1- 404 - 6393311
    Phone: 1- 800 - 3113435
    Web Address: http://www.cdc.gov
    
  
  
  
• • National Institute of Allergy and Infectious Diseases
    NIAID Office of Communications & Government Relations
    6610 Rockledge Drive, MSC 6612
    Bethesda , MD 20892-6612
    Phone: 1- 301 - 496-5717
    Phone: 1- 866 - 284-4107
    Web Address: www3.niaid.nih.gov
    

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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