Smallpox Vaccination: If the Choice is Left to You, What Will You Decide by Debra Otis

Recommendations and Notes from the CDC and the White House

Major Characteristics (Could also be chickenpox, contact dermatitis, shingles)
1. Fever above 101 one to four days before the rash, combined with headache, backache, chills, stomach distress or profound weakness
2. Classic lesions are firm, round and deep-seated in the skin, like an imbedded pea. Later they may develop a dimple in the center
3. Lesions develop in stages, they will all look the same on the same area of the body, not a mix of blisters and scabs

Minor Characteristics
1. Spots appear in a centrifugal pattern, clustering more on the face and limbs than trunk
2. First lesions are often inside mouth or palate, face or forearms.
3. Patient appears very sick even moribund
4. Lesions evolve slow: flat spot, raised bump, fluid-filled blister, pustule and scab. Each stage lasts 1-2 days.
5. Lesions appear on palms of hands and soles of feet

Evaluting Patients for Smallpox:
www.cdc.gov

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.
   • Life-threatening reactions can occur, including inflammation of the brain, ongoing infection of the skin with tissue destruction, and disfiguring and painful skin rashes

Who should not be vaccinated (CDC)
Individuals who have any of the following conditions, or live with someone who does:

   • Eczema or atopic dermatitis (even if the condition is not currently active, mild, or experienced as a child).
   • 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).
   • 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 one month of vaccination.

In addition, individuals should not receive the smallpox vaccine if they:
   • Are allergic to the vaccine or any of its ingredients.
   • 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.
   • Have a moderate or severe short-term illness. (These people should wait until they are completely recovered to get the vaccine.)
   • Are currently breastfeeding.
   • Pregnant or have plans to become pregnant within one month of vaccination.

CDC Smallpox info index

CDC public response hotline:
º English: (888) 246-2675 º Español: (888) 246-2857 º TTY: (866) 874-2646

FAQs from The White House