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Dryvax, |smallpox vaccine Smallpox Vaccine

smallpox vaccine

Generic Name: smallpox vaccine (SMALL pox)
Brand Names: Dryvax

What is smallpox vaccine?

Smallpox is a serious, contagious, and sometimes fatal infectious disease caused by the variola virus. Smallpox causes a rash on the face and body and fever. The last case of smallpox in the United States occurred in 1949. The last reported case of smallpox in the world occurred in 1977 in Somalia. Since the disease has been eradicated from the world by worldwide vaccination programs, routine vaccination is no longer required for prevention. Due to heightened concern that the variola virus might be used as an agent of bioterrorism, the U.S. government is taking precautions for dealing with a smallpox outbreak.

Smallpox may be spread from one person to another by direct and fairly prolonged face-to-face contact. It may also be spread through direct contact with infected bodily fluids or contaminated objects such as bedding or clothing. Rarely, smallpox has been spread by virus carried in the air in enclosed settings such as buildings, buses, and trains. A person with smallpox is sometimes contagious with onset of fever (prodrome phase), but the person becomes most contagious with the onset of rash. At this stage, the infected person is usually very sick and not able to move around in the community. The infected person is contagious until the last smallpox scab falls off.

The smallpox vaccine contains live vaccinia virus (a virus similar to smallpox), not dead virus like many other vaccines. For this reason, the vaccination site must be cared for carefully to prevent the virus from spreading. Also, the vaccine can have side effects. The vaccine does not contain the smallpox virus and cannot cause smallpox disease.

Smallpox vaccine can help prevent the disease. Many more people would get the disease if vaccination did not occur.

What is the most important information I should know about smallpox vaccine?

• a serious allergic reaction including swelling of the lips, tongue, or face; difficulty breathing; closing of the throat; hives; or rash within a few minutes to a few hours after the shot;

• eczema vaccinatum (serious skin rashes caused by widespread infection of the skin in people with skin conditions such as eczema or atopic dermatitis);

• progressive vaccinia or vaccinia necrosum (ongoing infection of skin with tissue destruction, frequently leading to death);

• postvaccinal encephalitis (inflammation of the brain);

• vaccinia rash or outbreak of sores limited to one area (Accidental spreading of vaccinia virus by touching the vaccination site and then touching another part of the body or another person. It usually occurs on the genitals or face, including the eyes, where ti can damage sight or lead to blindness. Washing hands with soap and water after touching the vaccine site will help prevent this.); or

• widespread vaccinia rash (The virus spreads from the vaccination site through the blood. Sores break out on parts of the body away from the vaccination site.).

People with minor illnesses, such as a cold, may be vaccinated. Those who are moderately or severely ill should usually wait until they recover before getting smallpox vaccine.

What should I discuss with my healthcare provider before receiving smallpox vaccine?

Smallpox vaccine uses a live strain of the vaccinia virus (a virus similar to smallpox). Because of this, the vaccination may cause side effects, possibly more severe people with decreased immune response. Before receiving smallpox vaccine, talk to your doctor if you or someone you live with:

• have HIV or AIDS or another disease that affects the immune system (e.g., an autoimmune disorder such as multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, others);

• are taking a medication that affects the immune system (e.g. steroids, anti-rejection medications);

• have cancer;

• have a skin condition such as burns, chickenpox, shingles, impetigo, herpes, severe acne, or psoriasis; or

• have or have had eczema or atopic dermatitis (even if the condition is not currently active, mild, or experienced as a child).

• heart problems such as previous heart attack, angina, congestive heart failure, cardiomyopathy (enlargement of the heart), chest pain or shortness of breath;

• a history of stroke or transient ischemic attack (TIA or "mini-stroke"); or

• three or more of the following risk factors for heart disease: high blood pressure; high blood cholesterol; diabetes or high blood sugar; have a first degree relative (e.g., father, mother, sister, brother) who had a heart condition before the age of 50; or smoke cigarettes.

Ask your healthcare provider for more information. Smallpox vaccine may not be recommended in some cases. Smallpox vaccine may still be needed if a person has been directly exposed to the smallpox virus, even if they have any of the conditions listed above.

People with minor illnesses, such as a cold, may be vaccinated. Those who are moderately or severely ill should usually wait until they recover before getting smallpox vaccine.

How is smallpox vaccine administered?

Your doctor, nurse, or other healthcare provider will administer the smallpox vaccine as an injection.

Smallpox vaccine is not administered as a conventional injection with which most people are familiar. The vaccine is given using a bifurcated (two-pronged) needle that is dipped into the vaccine solution. When removed, the needle retains a droplet of the vaccine. The needle is used to prick the skin a number of times in a few seconds. The pricking is not deep, but it will cause a sore spot and one or two droplets of blood to form. The vaccine usually is given in the upper arm.

If the vaccination is successful, a red and itchy bump develops at the vaccine site in three to four days. In the first week, the bump becomes a large blister, fulls with pus, and begins to drain. During the second week, the blister begins to dry up and a scab forms. The scab falls off in the third week, leaving a small scar. People who are being vaccinated for the first time have a stronger reaction than those who are being revaccinated.

After vaccination, it is important to follow care instructions for the site of the vaccine. Because the virus is live, it can spread to other parts of the body, or to other people. The vaccinia virus may cause rash, fever, and head and body aches.

Vaccination within 3 days of exposure to smallpox will prevent or significantly lessen the severity of smallpox symptoms in the vast majority of people. Vaccination 4 to 7 days after exposure likely offers some protection from disease or may modify the severity of disease.

Smallpox vaccination provides high level immunity for 3 to 5 years and decreasing immunity thereafter. If a person is vaccinated again later, immunity lasts even longer. Historically, the vaccine has been effective in preventing smallpox infection in 95 percent of those vaccinated. In addition, the vaccine was proven to prevent or substantially lessen infection when given within a few days of exposure. It is important to note, however, that at the time when the smallpox vaccine was used to eradicate the disease, testing was not as advanced o precise as it is today, so there may still be things to learn about the vaccine and its effectiveness and length of protection.

What happens if I miss a dose?

Since smallpox vaccine is given as a single dose, missing a dose will not occur.

What happens if I overdose?

An overdose of smallpox vaccine is unlikely to occur.

What should I avoid before or after getting smallpox vaccine?

There are no restrictions on food, beverages, or activity before or after receiving smallpox vaccine.

Smallpox vaccine side effects

Getting smallpox disease is much riskier than getting smallpox vaccine. However, a vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of smallpox vaccine causing serious harm, or death, is extremely small. In the past, about 1,000 people for every 1 million vaccinated for the first time experienced reactions that, while not life-threatening, were serious. Between 14 and 52 people out of every 1 million people vaccinated for the first time experienced potentially life-threatening reactions to the vaccine. Based on past experience, it is estimated that 1 or 2 people in 1 million who receive the vaccine may die as a result. Careful screening of potential vaccine recipients is essential to ensure that those at increased risk do not receive the vaccine. Most people who get smallpox vaccine experience normal, mild reactions.

• a serious allergic reaction including swelling of the lips, tongue, or face; difficulty breathing; closing of the throat; hives; or rash within a few minutes to a few hours after the shot;

• eczema vaccinatum (serious skin rashes caused by widespread infection of the skin in people with skin conditions such as eczema or atopic dermatitis);

• progressive vaccinia or vaccinia necrosum (ongoing infection of skin with tissue destruction, frequently leading to death);

• postvaccinal encephalitis (inflammation of the brain);

• vaccinia rash or outbreak of sores limited to one area (Accidental spreading of vaccinia virus by touching the vaccination site and then touching another part of the body or another person. It usually occurs on the genitals or face, including the eyes, where ti can damage sight or lead to blindness. Washing hands with soap and water after touching the vaccine site will help prevent this.); or

• widespread vaccinia rash (The virus spreads from the vaccination site through the blood. Sores break out on parts of the body away from the vaccination site.).

Other less serious side effects may occur. Talk to your doctor if you experience:

• soreness or redness of the arm where the vaccination is given;

• swelling of the glands in the armpits;

• low-grade fever; or

• one out of three people may feel bad enough to miss work, school, or recreational activity or have trouble sleeping.

Side effects other than those listed here may also occur. Contact your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect smallpox vaccine?

Talk to your doctor before receiving smallpox vaccine if you are taking any of the following medications that may affect the immune system:

• an oral or injectable steroid medication such as betamethasone (Celestone), cortisone (Cortone), dexamethasone (Decadron, Dexone), hydrocortisone (Cortef, Hydrocortone), methylprednisolone (Medrol), prednisolone (Prelone, Pediapred), prednisone (Orasone, Deltasone, others), or triamcinolone (Aristocort);

• an inhaled or nasal steroid such as beclomethasone (Qvar, Beclovent, Beconase, Vanceril, Vancenase), budesonide (Pulmicort, Rhinocort), flunisolide (Aerobid, Nasalide, Nasarel), fluticasone (Flovent, Flonase), mometasone (Nasonex), or triamcinolone (Azmacort, Nasacort);

• treatment for cancer with chemotherapy (medication), radiation, or x-rays;

• azathioprine (Imuran);

• basiliximab (Simulect);

• cyclosporine (Sandimmune, Neoral, Gengraf);

• etanercept (Enbrel);

• leflunomide (Arava);

• muromonab-CD3 (Orthoclone);

• mycophenolate mofetil (CellCept);

• sirolimus (Rapamune); or

• tacrolimus (Prograf).

Drugs other than those listed here may also affect smallpox vaccine. Tell your doctor about all prescription and over-the-counter medications you are taking, including vitamins, minerals, and herbal products.

Where can I get more information?

• Your doctor or pharmacist may have additional information or suggest additional resources regarding smallpox vaccine.

• Remember, keep this and all other medicines out of the reach of children, never share medicines with others, and use this medication only for the indication prescribed.
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