Smallpox - Protecting Yourself

by Holly Pence and Kelly Woods-Farrell

Beginning in January 2003, key military personnel and first-line health care workers will receive vaccine. In 2004, all Americans will be offered smallpox vaccinations on a voluntary basis. According to a recent poll by the Robert Wood Johnson Foundation, about two-thirds of Americans say they would be willing to have the vaccine.

Along with people with eczema, also at risk from the vaccine are people with immune diseases, people on immunity-suppressing drugs, infants, and pregnant women. Family members of these people should also not receive the vaccine. Altogether, it is estimated that as many as 50 to 100 million Americans should not receive the vaccine.

So, if you have eczema, your family may not receive vaccine directly, but what about health care workers or other people you may interact with? They may be vaccinated--will they be a danger to you?

The main risk is from contact transmission. Vaccinia, the virus used in the vaccine, is present at the inoculation site and can be passed on to another person, especially by hand-to-hand contact. Airborne transmission, such as from sneezes or coughs, can spread the smallpox disease itself in the case of an actual outbreak, but is not a factor with the vaccinia used in the vaccine.

The period during which a recently-vaccinated person is a threat is three weeks to one month. People who receive the vaccine will be instructed in methods of preventing contact transmission from themselves to others during the "danger period."

You can give yourself and family members further protection by the simple means of washing your hands. The vaccinia virus is not long-lived. Within 24 hours, 90% of vaccinia outside of a host (a person's body) will be dead. Washing causes the viruses to be removed and carried away by the water. It is not necessary to use an antibacterial cleanser. Just washing and rinsing well with your usual mild soap or cleanser of choice will be sufficient. Be sure to scrub all skin surfaces, including between the fingers. The hands should be washed anytime you have potentially had contact with a vaccinated person. Of course, any hand washing should be followed immediately with your favorite moisturizer.

For more technical information on smallpox and vaccination, see the "Smallpox" section of the Centers for Disease Control's comprehensive bioterrorism website at www.bt.cdc.gov/agent/smallpox/. The CDC also has a toll-free public information hotline at 888.246.2675 (English) or 888.246.2857 (Español).