Atopic Dermatitis and Smallpox Vaccinations Update 2011
Since the events of 9/11, government and health officials in the United States have been concerned that terrorists might one day use the smallpox virus as a weapon. In early 2003, the White House announced a plan to vaccinate active duty military personnel and healthcare professionals. In the case of a smallpox outbreak, millions of people would have received the smallpox vaccine.
But, people with atopic dermatitis (aka atopic eczema) or a history of atopic dermatitis (AD) are susceptible to developing a severe and potentially deadly skin disease called eczema vaccinatum (EV) after receiving the vaccine. Moreover, people with atopic dermatitis or a history of atopic dermatitis can develop EV even if they themselves do not get the smallpox vaccine, but simply come into close personal contact with people who have been recently vaccinated. This includes bandages, towels, clothing, or washcloths used by the person who has been vaccinated.
In 2003, the National Eczema Association (NEA) initiated a public awareness drive in response to the Federal Smallpox Campaign, educating the public regarding the life-threatening risks of developing EV. NEA has remained active in advocating for a vaccine suitable for atopic dermatitis patients and a coordinated effort by the National Institute of Allergy and Infectious Diseases (NIAID) to better communicate life saving information to both eczema patients who are most vulnerable, as well as governmental agencies.
There is progress! Bavarian Nordic, a Danish company, is working with the U.S. government (USG) to develop and stockpile IMVAMUNE®, a smallpox vaccine that does not produce severe adverse events like EV. Earlier this year, the results of a clinical Phase 2 trial of IMVAMUNE® in individuals suffering from atopic dermatitis was presented at the American Academy of Dermatology meeting. In this trial, 350 individuals with either a history of or currently active mild to moderate atopic dermatitis were vaccinated with IMVAMUNE®. Adverse reactions and immune responses were compared to 282 healthy subjects. Vaccination with IMVAMUNE® was well tolerated in both study populations, and subjects with atopic dermatitis generated strong vaccinia specific immune responses similar to healthy subjects.
Commenting on this study, NEA Scientific Advisor Richard Gallo, MD, PhD, Professor and Chair of Dermatology at University of California at San Diego, said that the preliminary data “look quite good in the mild to moderate groups.” Dr. Gallo did note that individuals at greatest risk for complications from the current smallpox vaccine, namely those suffering from severe forms of AD, were not included in this study. Plans to expand studies to include patients with more severe atopic dermatitis are anticipated closer to the date of full approval of the vaccine anticipated in 2013.
The NEA supports the continued development of smallpox vaccines that are safe for the millions of Americans that live with atopic dermatitis. The NEA welcomes the stockpiling of IMVAMUNE® and encourages the USG to communicate the risks of traditional smallpox vaccines and ensure that in the event of an emergency AD sufferers have access to newer vaccines.