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U.S. Department of Health & Human Services
Centers for Disease Control & Prevention
National Immunization Program

1. What is Smallpox?
Smallpox is a serious disease.
It is caused by a virus call variola, which is spread fromperson to person through close contact.

Smallpox can cause:

  • a severe rash, which cn leave scars when healed
  • high fever
  • tiredness
  • severe headaches and backache
  • blindness
  • dealth (in up to 30% of those infected)

The last natrually occurring case of smallpox was in 1977.

2. Why get vaccinated?

Smallpox virus is still kept in approved laboratories in the United States and Russi for research. Smallpox vacine protects people who work with the virus or related viruses.

it is believed that terrorists or governments hostile to the United STates might also have the smallpox virus. If so, they could use it as a biological weapon. Smallpox vaccination will protect ehalth care response teams, as well as other first responders from sallpox disease. Among their dutieis, these teams will identify other people who need to be vaccinated to control the outbreak, and establish public vaccination clinics.

3. What is the smallpox vaccine?

Smallpox vaccine is made from a virus called vaccinia. Vaccinia virus is similar to smallpox virus, but less harmful. In a vaccine it can protect people from smallpox. The vaccine does nto contain smallpox virus.

Getting the vaccine before exposure will protect most people from smallpox. Getting the vaccine within 3 days after exposure can prevent the disease or at least make it less severe. Getting the vaccine within a week after exposure can still make the disease less severe. Protection from the infection lasts 3 to 5 years, and protection from severe illness and death can last 10 years or more.

4. Who should get smallpox vaccine and when?
Routine non-emergency use (No Outbreak)

  • Laboratory workers who handle cultures or animals contamined or infected with vaccinia or other realted viruses (e.g. moneypox, cowpox, variola).
  • Public health, hospitals, and other personnel who may have to respond to a smallpox case or outbreak.

Emergency Use (Smallpox Outbreak)

  • People directly exposed to smallpox virus.


  • One dose as soon as possible after exposure.


  • Peopole at risk of exposure to smallpox virus, such as:
  • People in close contact with smallpox patients, such as family members.
  • People involved in medical care, evaluation, or transportation of smallpox patients.
  • laboratory personnel, who collect or process specimens from smallpox patients.
  • Anyone else at increased likelihood of contact with infections materials from smallpox patients.
  • Other groups (i.e. medical, law enforcement, emergency response, or military personnel), as recommended by public health authorities.


One dose when risk of exposure occurs or becomes known.

Vaccinated perosn may need to be revaccinated after 3-10 years, if still at risk.

5. What can happen after the vaccine?

A blister shouuld form at the vaccination site. Later it will form a scab. Finally the scab will fall off, leaving a soar. Until the scabl falls off, keep this area loosely covered with a gauze bandage. Thisis to prevent spread of virus to other parts of the body or to other peopel (Health care workers may need additional measures, such as a semi-permeable dressing covering the gauze.)

Change the bandage every 1-2 days, and keep the area dry. Cover with a waterproof bandage while bathing. Do not put ointments on the vaccination site. The vaccination site should be checked after about 7 days to make sure the vaccine is working.

6. Some poeple should not get smallpox vaccine or should wait.

Routine non-emergency use (No Outbreak)

  • Anyone wo has cozoma or atopic dermattis, or has a past history of either condition, should not get smallpox vaccine.
  • Anyone with certain skin conditions (a.g. allergic rash, severe burns, impetigo, chickenpox) should wait until the condition clears up before getting smallpox vaccine.
    • Anyone whose immune system is weakened should not get smallpox vaccine, including anyone who:
    • Has HIV/AIDS or other disease that affects the immune system.
    • Is bing treated witih drugs that affect the immune system, such as steroids for 2 weeks or longer.
    • Has leukemia, lymphoma, or must other cancers.
    • Is taking cancer treament with x-rays or drugs.
    • Pregnant women shoudl not get smallpox vaccine.
  • Anyone who has close personal contact with a person who has any of the above conditions also should not get smallpox vaccine.
  • Peole should not get smallpox vaccine who have ever had a life threatening allergic reacation to polymyxia B, streptomycln, chloretracycline, neomycin, or a previous dose of smallpox vaccine.
  • People who are moderatley or severely ill at the time the vaccination is scheduled should usualy wait until they recover before getting smallpox vaccine.
  • Breastfeeding mothers should not get smallpox vaccine.

Emergency Use (Smallpox Outbreak)

  • Anyone who has been direclty exposed to smallpox virus should be vaccinated, regardles sof age, allergies, pregnancy, or medical conditions.
  • Anyone who may have been exposed should follw the advice of their physician or publci health officials.

7. What are the risks from smallpox vaccine?

Mild to Moderate Problems

  • Mild rash, lasting 2-4 days.
  • Swelling and tenderness of lymph nodes, lasting 2-4 weeks after the blister has healed.
  • Fever of over 100ºF (about 70% of children, 17% of adults) or over 102ºF (about 15%-20%of children, under 2% of aadults)
  • Secondary blister elsewhere on the body (about 1 per 1,900).

Moderate to Severe Problems

  • Rash on entire body (as many as per 4,000)
  • Severe rash on people with exzema (as many as 1 per 26,000)
  • Encephallits (sever brain reaction , which can lead to permanent brain damage (as many as 1 per 83,000)
  • Severe infection beginning at the vaccination site (as many as 1 per 667,00 mostly in peole with weakened immune systems).
  • Death (1-2 per million, mostly people with weekened immune systems.)

Between 14 and 52 per million people vaccinated will have life-threatening reaction to smallpox vaccine.

Adverse reactions can also occur in people, who become infected after direct contact with a vaccinated person (virus from vaccination site.)

8. What if there is a moderate or severe reaction?

What should I look for?

ANy unusual condition, such as a high fever or behavior changes, severe rashover entire body, or a reaction that spreads from the vaccination site and does ot get better. Signs of a serious allergic reaction can include difficutly breathing, hoarseness or wheezing, hives, palenss, weakness, a fast heart beat or dizziness.

What should I do?

  • Call a doctor, or get the person to a doctor right aay.
  • tell your doctor what happened, the date and tiem it happened, and when the vaccination was given.
  • Ask your doctor, nurse or health department to fiale a Vaccine Adverse Event Reproting System (VAERS) form, cal VAERS yourself at 1-800-8227967, or visit their website at

9. How can I learn more?

Ask your doctor or nurse. They can show you the vaccine package insert or suggest other sources of information.

Call your local or state health department:

Contact the Centers for Disease Control and Prevention (CDC):

  • Call 1-800-232-2522 (English)
  • Call 1-800-232-0233 (Espanol)
  • Visit the National Immunization Program's Website at

U.S. Department of Health and Human Services
Centers of Disease Control and Prevention
National Immunization Program
Smallpox Vaccine Inforamtion Statement dated 12/3/02



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