Generic Name: smallpox vaccine (SMALL pox)Brand Names: Dryvax
Smallpox is a serious, contagious, and sometimes fatal infection that is caused by a virus. Smallpox causes fever and a blistering skin rash. These blisters contain virus and can make the infected person highly contagious.
Smallpox is spread from person to person through direct contact, or by coming into contact with infected bodily fluids or contaminated objects such as clothing or bedding. A person with early symptoms of smallpox may or may not be contagious. Once the person forms a smallpox skin rash, the chance of spreading the disease increases until the last smallpox has scab fallen off.The smallpox vaccine contains live "vaccinia" virus (a virus similar to smallpox). For this reason, the vaccination site (the place on your skin where the vaccine is injected) will be contagious and can spread the virus to other parts of your body or to other people.
The smallpox vaccine is not given as a routine vaccination to children or adults because the dedicated use of smallpox vaccine in the first half of the 20th century has virtually eliminated the disease worldwide. The last case of smallpox in the United States occurred in 1949. The last reported case of smallpox worldwide occurred in 1977.
Recent concerns that smallpox virus might be used as a weapon of bioterrorism has led U.S. health officials to take precautions for a smallpox outbreak. The smallpox vaccine is currently recommended for military and civilian personnel who work in high threat areas, and in healthcare and safety workers who may provide first-response care in an outbreak. Smallpox vaccine is also recommended for laboratory workers who may be exposed to the smallpox virus or closely related viruses.
You should also not receive a smallpox vaccine if you or someone in your household has a skin disorder such as eczema (Atopic dermatitis), or a weak immune system caused by disease or by taking certain medicines such as steroids.If you have a high risk of exposure to smallpox, you may need to receive the vaccine even if you have any of the above conditions.
Before receiving the vaccine, tell your doctor if you have asthma, diabetes, kidney disease, or an autoimmune disorder such as MS, rheumatoid arthritis, or lupus. Tell your doctor if you are allergic to latex rubber, if you have recently used a steroid eye drop, or if you have any risk factors for heart disease.
A vaccination sore will appear on your skin within 3 to 4 days after you receive this vaccine. This sore may itch and will gradually form a blister filled with pus. As the blister drains and dries up, a scab will form. After you receive the vaccine and until your scab falls off, your vaccination sore will be "contagious" and could spread the virus to anything or anyone who touches it.
Keep your vaccination sore covered with a gauze bandage to keep from spreading the virus to other people or to other parts of your own body. Change your bandage at least once a day.Always wash your hands with soap and hot water after touching your sore, changing bandages, or handling clothing or other fabrics that have come into contact with your sore.
Avoid touching the sore and then touching other parts of your body (especially your eyes) until you have washed your hands.Call your doctor at once if you have chest pain, muscle or joint pain, dry cough, feeling short of breath, flu symptoms, stiff neck or back, vomiting, confusion, memory loss, irritability, loss of balance or coordination, problems with speech or vision, sensitivity to light, muscle weakness or paralysis, seizure (black-out or convulsions), a severe skin rash, irritation, infection, or skin changes, or an outbreak of skin sores or blisters anywhere on your body. Keep track of any and all side effects you have after receiving this vaccine. If you ever need to receive a booster dose, you will need to tell the doctor if the previous dose caused any side effects.
Becoming infected with smallpox is much more dangerous to your health than receiving the vaccine to protect against it. Like any medicine, this vaccine can cause side effects, but the risk of serious side effects is extremely low.What should I discuss with my healthcare provider before receiving smallpox vaccine?You should not receive this vaccine if you have ever had a life-threatening allergic reaction to any vaccine containing vaccinia virus, or if you have:
a heart condition such as coronary artery disease, congestive heart failure, or chest pain (angina);
a history of heart attack, stroke, or"mini-stroke";
a weak immune system caused by disease (such as cancer, HIV, or AIDS), or by taking certain medicines such as steroids;
a skin wound, burn, infection such as impetigo or shingles (herpes zoster), or disorder such as eczema (atopic dermatitis);
an allergy to antibiotics such as neomycin, polymyxin B, streptomycin, or tetracycline.
if someone in your household has a weak immune system or a skin disorder such as eczema;
if you are pregnant or breast-feeding; or
if you have received cancer chemotherapy or radiation treatment in the past 3 months.
Before receiving this vaccine, tell your doctor if you are allergic to any drugs, or if you have:
a chronic disease such as asthma or other breathing disorder, diabetes, kidney disease, or blood cell disorders such as anemia;
an autoimmune disorder such as multiple sclerosis, rheumatoid arthritis, or systemic lupus erythematosus;
an allergy to latex rubber;
if you have recently used a steroid eye drop; or
if you have at least 3 heart risk factors such as smoking, diabetes, high cholesterol, high blood pressure, or a family history of heart disease in a person younger than 50.
You can still receive this vaccine if you have a cold or fever. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.
This vaccine is not given with a needle and syringe, as most other vaccines are. Instead, the smallpox vaccine is given using a two-pronged needle that is dipped into the vaccine solution and then used to prick the skin several times to deliver the vaccine into the shallow layers of skin. These needle sticks are not deep, but they will cause some soreness and minor bleeding.
Smallpox vaccine usually is given in the skin of your upper arm. You will receive this injection in a doctor's office or other clinic setting.
Within 3 to 4 days after receiving this vaccine, you should see a small red bump on your skin where the needle was placed. This bump may itch and it will gradually grow larger and form a blister filled with pus that will eventually drain. During the second week the blister should dry up and form a scab. After the scab falls off during the third or fourth week, you will most likely have a small scar.Smallpox vaccine contains a live form of the virus. This means that after you receive the vaccine and until your scab falls off, your vaccination sore will be "contagious" and could spread the virus to anything or anyone who touches it.
A vaccination sore can transfer smallpox virus to bandages, clothing, bedding, towels, wash cloths, or furniture.
Keep your vaccination sore covered at all times with a gauze bandage, especially while the sore is draining pus. This bandage will provide a barrier to protect against spreading the virus to other people or to other parts of your own body. Change your bandage at least once a day, or as needed to keep the sore clean and dry.
Use a gauze bandage held in place with first aid tape. The bandage should allow air to flow through it to keep your vaccination sore dry. Do not apply ointments or salves to the sore. Use a waterproof bandage to cover the sore while you are bathing. Apply a dry gauze bandage after bathing. Be sure to wash your hands with soap and hot water after changing your bandage.
Throw away used bandages in a sealed plastic bag placed in a garbage can that children and pets cannot reach. Do not allow anyone else to handle your used bandages.Always wash your hands thoroughly with soap and hot water after touching your vaccination sore, changing your bandages, or handling clothing, towels, or other fabrics that have come into contact with your sore. You may also use an alcohol-based hand rub such as Purell.
The virus can also spread to other parts of your body that come into contact with your vaccination sore. Avoid touching the sore and then touching other parts of your body (especially your eyes) until you have washed your hands.
Wear a shirt at all times to cover your vaccination sore while it is healing. If you share a bed with someone, wear a shirt or pajamas to keep from spreading the virus to your bedding or to the other person.Do not share towels, clothing, or other personal items while your vaccination sore is healing. Use a separate laundry basket or hamper for your clothing, towels, and bedding. All of your laundry should be washed in hot water with detergent and bleach (if possible) to kill any smallpox virus remaining on these items.
Get medical help if someone in your household shows any symptoms of smallpox, such as skin rash, fever, headache, or body aches. These may be signs that the virus has spread to that person or to something in the household that the person has touched.When your scab falls off, place it in a sealed plastic bag and throw it away. Wash your hands with soap and hot water afterward.
This vaccine can cause false results on a skin test for tuberculosis. Tell any doctor who treats you if you have received a smallpox vaccine within the past 4 to 6 weeks.
An overdose of smallpox vaccine is unlikely to occur.
Avoid touching your vaccination sore and then touching other parts of your body (especially your eyes) until you have washed your hands. Accidentally spreading the virus to your eyes can lead to permanent vision loss.
Avoid touching your vaccination sore and then touching another person. The smallpox virus in the vaccination sore is highly contagious.
Do not scratch or pick at the sore, as this will greatly increase the risk of spreading the virus to other parts of your body or to other people.
Becoming infected with smallpox is much more dangerous to your health than receiving the vaccine to protect against it. Like any medicine, this vaccine can cause side effects, but the risk of serious side effects is extremely low.Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
chest pain, muscle or joint pain, dry cough, feeling short of breath;
flu symptoms, stiff neck or back, vomiting, confusion, memory loss, irritability, loss of balance or coordination;
problems with speech or vision, sensitivity to light, muscle weakness or paralysis, seizure (black-out or convulsions);
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
irritation, infection, or skin changes where the needle stick was placed; or
outbreak of skin sores or blisters anywhere on your body.
Less serious side effects include headache, low fever, and swollen glands.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Smallpox Prophylaxis:
1 drop applied by intradermal multiple-puncture technique (scarification).
Usual Geriatric Dose for Smallpox Prophylaxis:
1 drop applied by intradermal multiple-puncture technique (scarification). Routine nonemergency vaccination is not recommended for geriatric individuals. There are no absolute contraindications to vaccinations in persons with a high-risk exposure or during an outbreak emergency.
Usual Pediatric Dose for Smallpox Prophylaxis:
1 drop applied by intradermal multiple-puncture technique (scarification).<12 months: Routine nonemergency vaccination is contraindicated.1 year to 18 years: Routine nonemergency vaccination is not recommended.There are no absolute contraindications to vaccinations in persons with a high-risk exposure or during an outbreak emergency.
Also tell the doctor if you have recently received drugs or treatments that can weaken the immune system, including:
an oral, nasal, inhaled, or injectable steroid medicine;
medications to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders, such as azathioprine (Imuran), efalizumab (Raptiva), etanercept (Enbrel), leflunomide (Arava), and others; or
medicines to treat or prevent organ transplant rejection, such as basiliximab (Simulect), cyclosporine (Sandimmune, Neoral, Gengraf), muromonab-CD3 (Orthoclone), mycophenolate mofetil (CellCept), sirolimus (Rapamune), or tacrolimus (Prograf).
If you are using any of these medications, you may not be able to receive the vaccine, or may need to wait until the other treatments are finished.
There may be other drugs that can affect this vaccine. Tell your doctor about all the prescription and over-the-counter medications you have received. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.