Questions and Answers About Smallpox Vaccine
What is smallpox vaccine?
The smallpox vaccine helps the body develop immunity to smallpox. The vaccine is made from a virus called vaccinia which is a "pox"-type virus related to smallpox. The smallpox vaccine contains the "live" vaccinia virus—other vaccines containing live virus include measles, mumps, and German measles. For that 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 give you smallpox. (Apr 28, 2003) How long is the vaccinia virus viable on clothing, towels, dressing, etc.? There is an experiment that attempts to shed light on this question. It is noted in a 1976 Western J. Med article and referenced in Sepkowicx NEJM study on nosocomial transmission, Johnson et al 1976 Nosocomial Vaccinia Transmission. In this experiment smallpox vaccine was reconstituted, allowed to dry on a slide, then reconstituted after room temp incubation for 0-144 hours. At 78 hours saw drop in viability, at 144 hours, no longer viable. There has been no documented case of fomite transmission.
Vaccination and Clinic Operations
What is the current thinking on vaccinating the vaccinators?
Vaccinators can be vaccinated at the time they begin vaccinating but it may be preferable to vaccinate vaccinators earlier than that to eliminate the possibility that the vaccinators may be experiencing vaccine-related symptoms and not feel well enough to work for a few days (possibly up to 1/3), usually ~7-10 days after begin vaccinated. Each state will determine how they will vaccinate vaccinators.
Who specifically among the vaccination clinic staff should be vaccinated? Do we include all clerical staff, as well?
To minimize the clinical impact of inadvertent inoculation, should it occur, ACIP recommends that persons who will be handling and administering smallpox vaccine in the proposed pre-event smallpox vaccination program be vaccinated. It is not necessary for anyone not handling the smallpox vaccine to be vaccinated.
Are nurses the only ones who can administer smallpox vaccine?
The vaccine can be administered by nurses, doctors, or other licensed health care professionals. Whether or not non-clinical personnel can be used in a vaccination clinic is dependent on state laws. Local health agencies should consult with their state health department on what is allowable.
The Privacy Act statement says that all of the information on the patient screening form is voluntary. Is it truly voluntary? How does this work legally?
The screening worksheet is a voluntary tool for individuals considering vaccination. It is not collected and the information is not elicited. However, the Patient Medical History and Consent Form, does elicit information. Vaccinees are asked to provide demographic information, vaccination and medical history information, and are asked whether they have any of the conditions that would mean they should not be vaccinated. They also are asked to provide a consent signature acknowledging their agreement to proceed with vaccination.
Does CDC expect all adverse events will be entered into www.vaers.org?
If so, will the current form be modified to have smallpox specific information on it? All adverse event information should be entered in VAERS using the form as it currently stands.
Centers for Disease Control and Prevention content is free and public domain.
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