HEALTH & SCIENCE

Smallpox vaccine hazards dictate cautious approach

With the greater number of immunocompromised people today, there are more public health concerns with immunization policy than in past years.

By Susan J. Landers, AMNews staff. Aug. 19, 2002.

Washington -- Physicians receiving or administering the smallpox vaccine as part of a federal plan to counter bioterrorism should be aware that the recipient of the vaccine isn't the only one at risk for complications.

"There is a significant possibility of person-to-person transmission," noted Scott D. Deitchman, MD, MPH, chair of the AMA's bioterrorism subcommittee and a member of the AMA Council on Scientific Affairs.

The risk is substantial, as the vaccination site will harbor a large amount of live virus capable of replicating, he said. The risk subsides when the site scabs over, two weeks or more after immunization.

The vaccine itself is probably the "least safe human vaccine," said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases at a July 25 briefing on smallpox vaccination sponsored by the Alliance for Health Reform.

Complications can result in death for vaccine recipients as well as for those they come into contact with.

Physicians will need to counsel patients about the risk of spreading the vaccinia virus used in the smallpox vaccine either to other members of their households or to other parts of their own bodies, said Dr. Deitchman.

They will have to warn against scratching the very itchy site, keeping the site covered with a dressing, washing hands after changing the dressing and putting the used dressing in a sealed plastic bag, he said. Additional difficulties could arise when trying to protect small children from complications. [...]

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