Smallpox Vaccine Risky Even for Those Who Don't Get It

The January 19, 2003 issue of the Seattle Times adds more controversy and fire to the debate on the idea of performing mass smallpox vaccinations in response to the threat of a terrorist attack.  The article starts off by stating, "More than 800,000 people in Washington state — about one in seven residents — could risk a severe reaction from close contact with a person recently vaccinated against smallpox, combined estimates from health authorities and state officials indicate.

The article says that the authorities define severe reactions as ranging from a painful, widespread rash to death.  In explaining the process the article states that the smallpox vaccine is not given as a regular shot; instead, it is inserted into layers of the skin with repeated pricks of a small needle. The vaccination site is then kept covered until it heals. Direct skin contact with secretions from vaccination wounds could set off the complications. These contacts include touching bedding, towels or clothing thus spreading the secretions.

These secretions contain live vaccinia virus, a cousin of the smallpox virus which supposedly tricks healthy immune systems into building a smallpox defense. The vaccinia virus is the active component of the smallpox vaccine. These vaccination sites are contagious for about three weeks, until the scab falls off. The problem is then that those who are vulnerable can contract severe "vaccinia," which is caused by this virus.  Additionally, secretions that touch healthy people could cause a rash that, if it gets into the eye, could cause permanent damage.

Judith Billings, chair of the Washington State Governor's Advisory Council on HIV/AIDS says, "We do not want to discourage people from getting health care because they are scared (of vaccinated healthcare workers)   But we want them to know there are risks and that they should take the appropriate actions."

The article stated that there are groups of people who would be more at risk from contact with people who have been vaccinated.  These groups include anyone who has had eczema or atopic dermatitis, or anyone who has had one of many other types of skin disorders.  Additionally at risk are pregnant women, infants under age 1, people with HIV, cancer patients, patients who have had organ transplants, and the elderly.