With the announcement of the new national smallpox response plan, many people are trying to decide if they will or should get the smallpox vaccine. While the government is not recommening that the general public be vaccinated at this time, those who insist on being vaccinated will have the opportunity.
The decision to receive the vaccine should be made by carefully weighing the risk of contracting smallpox versus the risk of developing side effects of the vaccine. The Bush Administration has stated that it has "no evidence that a smallpox attack is imminent," therefore the risk to the general public of contracting smallpox is low.
- There are groups of people who, because of their jobs, are at a higher risk of being infected with smallpox. These people should receive the smallpox vaccine.
- There are also groups of people who are at a much higher risk than the general public of developing side effects. These people should absolutely not get the vaccine.
- In the event of a smallpox outbreak, all people exposed to the virus should get the vaccine, regardless of whether they are at risk of side effects.
High Risk of Exposure to Smallpox - (Should Get the Vaccine)
Under the new national smallpox response plan the following people will receive the smallpox vaccination:
- Military personnel who are or could be deployed to a high threat area
- Civilian personnel working for the Department of Defense who are or could be deployed to a high threat area
- Health care workers and first responders who will make up the smallpox response teams
High Risk of Side Effects to Individual and Household Contacts- (Should NOT Get the Vaccine)
People who have any of the following conditions, or live with someone who does, are at a high risk of developing serious side effects to the vaccine, and should not get the vaccine unless exposed to smallpox:
- Eczema or atopic dermatitis - even if the disease is not active now
- Skin conditions that result in a break in the skin such as burns, chickenpox, shingles, impetigo, herpes, severe acne, and psoriasis. These people should wait until their skin condition has completely healed.
- Weakened immune system such as someone who has received a transplant, is HIV positive, or receiving treatment for cancer.
- Anyone taking immune suppressing medications like corticosteroids (Prednisone, Medrol)
- Pregnant women
High Risk of Side Effects to Individual - (Should NOT Get the Vaccine)
People who have the following conditions are at a high risk of developing side effects to the vaccine, and should not get the vaccine unless exposed to smallpox:
- Women who are breast-feeding
- Children under 12 months, although the Advisory Committee on Immunization Practices (ACIP) recommends that children under 18 years old not get vaccinated unless exposed.
- Allergies to the vaccine or any of its components - polymyxin B sulfate, streptomycin sulfate, chlortetracycline hydrochloride, neomycin sulfate, and phenol
- A moderate or severe short-term illness - vaccination should be deferred until the illness has resolved.
People in the general public who insist on being vaccinated, will be able to be vaccinated in 2003 with an unlicensed vaccine, in 2004 with a licensed vaccine, or may volunteer for an on-going clinical trial for a next-generation vaccine. The Department of Health and Human Services is working now to establish an orderly process for these options to be exercised.
Information for this article was taken from
-Centers for Disease Control Smallpox Vaccine Contraindications
-Department of Health and Human Services Who Should NOT be Vaccinated
