Smallpox Vaccine

GENERAL INFORMATION:

What is smallpox? Smallpox is a very serious disease caused by an infection with a type of virus (germ) called variola. People who have this disease develop fever with a skin rash and blisters that spreads all over the body. Smallpox is easily spread from person to person and caused death to many people in past centuries. The disease of 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 are used to help decrease your risk of becoming infected with 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 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 type of live virus called vaccinia. This virus is also a pox-type virus like the variola virus, but does not cause smallpox. When given this vaccine also helps protect your body 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 within 10 days of getting it. Your body has decreased protection as years pass. Getting vaccinated again later gives protection from the disease that lasts longer.

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 10 or more years ago for smallpox 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:

• Health 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, leaving a droplet of the vaccine when removed. Pricking is done a number of times in a few seconds. This causes a sore spot and small blood droplets to form.

What happens after receiving 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 fluid-filled bump dries up and forms a scab. The scab then falls off 3 to 4 weeks after getting the vaccine, leaving a scar.
  
  
• Normal, mild reactions: You may have any of the following reactions after getting the vaccine:
  
  
  • Itching and redness around the vaccine area on the arm.
    
    
  • Enlarged lymph nodes (glands) in the armpits.
    
    
  • Fever.
    
    
  • Sore arm with swelling where the vaccine was given. Swelling and pain of the vaccinated area may happen in 3 to 10 days after receiving 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 be done after being vaccinated? After getting 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 the vaccinated area is touched and then another part of the body is touched. The virus may also spread by touching things that have touched the vaccinated area. These things commonly include bandages, sheets, clothes, and towels.

• After receiving the vaccine, it is important to take care of your 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 water-proof 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. These are true unless there is a smallpox outbreak and you have been exposed to the virus. The following increase the risk of having bad effects with the smallpox vaccine:

• Allergy: People who have an allergy to the vaccine or certain antibiotic medicines. These include polymyxin B, streptomycin, neomycin, and chlortetracyclin.
  
  
• Children and elderly: Children younger than 12 months of age should not receive the vaccine. Having a child this age, however, should not be a reason for you not to be vaccinated. It is also not advised for children younger than 18 years of age to have it. Adults 65 years or age and older are also not advised to receive the vaccine except in emergency situations.
  
  
• Heart and related conditions: Having a heart condition may put you at higher risk for heart problems after receiving the vaccine. Having frequent contact with someone who has a heart condition is not a reason not to be vaccinated. 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 three or more of the following:
  
  
  • A close family member (parent or sibling) who got a heart condition before the age of 50.
    
    
  • Diabetes or high blood sugar as checked by your caregiver.
    
    
  • High blood pressure as checked by your caregiver.
    
    
  • High blood cholesterol (fat) as checked by your caregiver.
    
    
  • You are a smoker at present.
  
  
• Skin conditions: People who have or have had skin conditions, such as eczema or atopic dermatitis.
  
  
• Weak immune system: The immune system is the part of your body that fights infection. This 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.
  
  
• Other conditions: Women who are pregnant or breastfeeding should not receive the vaccine. Getting vaccinated while pregnant puts your unborn baby at risk of being infected. 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 with getting it 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 of spreading 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, and your eyes or brain may get long-term damage. Some of these infections can be life-threatening.

How are bad reactions to the smallpox vaccine treated? There are no medicines approved for treating bad reactions to the smallpox vaccine. With certain reactions, vaccinia immune globulin (VIG) may help. 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.
  
  
  • 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.
    
    
  • 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, eyes are common areas infected. Infection of the eyes with the vaccinia virus may lead to problems with your sight or blindness.
    
    
  • Widespread rash or sores. This may happen when the virus enters the blood.
  
  
• Very serious reactions:
  
  
  • Damage and death of the skin and tissues under the vaccinated area.
    
    
  • Skin rashes in people with a skin condition, such as eczema or atopic dermatitis.
    
    
  • Swelling of the brain.

What should I do if I develop a serious reaction to smallpox vaccine?

• If you have any of the following symptoms, call your caregiver:
  
  
  • The wound from your 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.
  
  
• If you have any of the following symptoms, seek immediate medical care:
  
  
  • Chest pain, convulsions, or passing out.
    
    
  • High fever or shaking chills.
    
    
  • Hives or rashes that have spread all over the body. Hives are red, itchy bumps with burning feeling on the skin.
    
    
  • Swelling of the face, mouth, and throat.
    
    
  • Trouble thinking clearly or changes in behavior.
    
    
  • Weakness, dizziness, or a fast heartbeat.
    
    
  • Wheezing or 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 Allergies and Infectious Diseases
    NIAID Office of Communications & Public Liaison
    6610 Rockledge Drive, MSC 6612
    Bethesda, Maryland 20892-6612
    Phone: 1-301-496-5717
    Web Address: www3.niaid.nih.gov
    
  
  
  
• If you were injured after receiving the vaccine, you may file a claim to the National Vaccine Injury Compensation Program . This is a federal program that helps pay for the care of anyone seriously injured or harmed by a vaccine. Contact information:
  • Health Resources and Services Administration National Vaccine Injury Compensation Program
    Parklawn Building, Room 11C-26, 5600 Fishers Lane
    Rockville , MD 20857
    Phone: 1-800-338-2382
    Web Address: http://www.hrsa.gov/vaccinecompensation/
    

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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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