Smallpox vaccine and people with skin conditions
The last case of naturally occurring smallpox was seen in 1977. In 1980, the World Health Organization (WHO) declared the disease eradicated and recommended that all countries cease vaccinating people against the disease. However, in response to the possibility of smallpox being used as a biological weapon, the Centers for Disease Control and Prevention (CDC) has developed recommendations for people with skin conditions. These recommendations are also used in Canada.
What risks does the smallpox vaccine pose to people with skin conditions?
All people receiving smallpox vaccine have risks from the vaccine.
In addition, people with skin conditions such as eczema or atopic dermatitis have an increased risk of developing a severe rash called eczema vaccinatum if they receive the smallpox vaccine or touch another person’s vaccination mark before the scab has fallen off. Although most people recover from eczema vaccinatum, the rash can be quite severe, sometimes leading to death.
People who do not have eczema at the time of vaccination but who have a history of eczema also are at increased risk of developing eczema vaccinatum.
Should people with skin conditions get the smallpox vaccine?
In an outbreak, everyone who has been in contact with a person who has smallpox or was exposed to the virus should get the vaccine, regardless of age, allergies, pregnancy, or medical conditions.
If you have one of the skin conditions listed above and have been exposed to smallpox, you will be advised to have the vaccine because your risk of getting the disease is greater than any additional risks from the vaccine. Also, getting a shot of vaccinia immune globulin (VIG) may keep the eczema vaccinatum rash from becoming severe.
If you have one of the skin conditions listed above and have not been exposed to smallpox, you should not be vaccinated because your risk of getting the disease is less than any risks from the vaccine.
If someone in your household requires vaccination and you have a high-risk skin condition, you should not have contact with or live with the person until the scab has fallen off his or her vaccination site.
If I am vaccinated, what would indicate a serious reaction?
Watch for fever, a severe rash or blisters on your body, or a reaction that spreads from the vaccination site and does not get better.
[Adapted from the CDC's Smallpox Vaccination Clinic Guide1]
| Author: | Debby Golonka, MPH Carrie Henley | Last Updated: May 1, 2007 |
| Medical Review: | William M. Green, MD - Emergency Medicine Anne C. Poinier, MD - Internal Medicine W. David Colby IV, MSc, MD, FRCPC - Infectious Disease Christine Hahn, MD - Epidemiology | |
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