Published Date: 2003-03-01 23:50:00
Subject: PRO/EDR> Smallpox vaccination, adverse events - USA
Archive Number: 20030301.0515
SMALLPOX VACCINATION, ADVERSE EVENTS - USA
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: 1 Mar 2003
From: ProMED-mail <email@example.com>
Source: New York Times / AP 1 Mar 2003 11:54 AM EST [edited]
Patient Has Smallpox Related Infection
Doctors in California are trying to determine how an adult's eye became
infected with the same virus used in the military's smallpox vaccination
The patient, who has not been identified, had been in close contact with
someone who had been inoculated, health officials said. However, Dr.
Jonathan Fielding, Los Angeles County's director of public health, said it
remained unclear exactly how the patient became infected.
The vaccine is made with a live virus that can be spread by touching a
vaccination site before it has healed or by touching bandages, clothing or
other material contaminated with the live virus.
"We really don't know how it happened -- it could have happened in a
variety of ways," Fielding said. "What's important is they had direct
contact with the person, rather than this being something that was just in
Public health officials have declined to release the patient's gender or
age, but have said the patient's condition was improving.
It was the first known case in California linked to the national drive to
vaccinate emergency health workers and military personnel.
In Florida, officials are investigating medical problems among 3 health
care workers who became ill after receiving the vaccine. Only one appears
to have had a reaction to the inoculation, with the other 2 experiencing
symptoms not normally related to the inoculations. [see Smallpox Vaccine
Adverse Events Among Civilians --- United States, February 18--24, 2003,
MMWR 28 Feb 2003.
52(08);156-157 <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5208a4.htm> -
As of last week, 7354 people had been vaccinated in 38 states and Los
Angeles and New York, which are running separate programs.
In the military, where more than 100 000 people have been vaccinated, there
have been 5 serious reactions. All 5 men are in good condition, officials
said. In most cases, the symptoms were not severe.
[As there are increasing numbers of people vaccinated with the smallpox
vaccine, not unexpectedly we are beginning to see reports of some
significant adverse events. This is the first mention of an adverse event
occurring in a contact of a recent vaccinee in the USA (in the ProMED-mail
posting Smallpox vaccination strategy - Israel (03) 20021222.6113 there
is discussion about 2 cases of generalized vaccinia in contacts of recent
vaccinees in Israel in 2002). In an AP newswire on 1 Feb 2003, there was
mention of one case of generalized vaccinia and one case of encephalitis in
military personnel vaccinated with the smallpox vaccine. The above
newswire mentions there were 5 cases of serious adverse
events. Anecdotally we learned of a recent male vaccinee (an infectious
disease physician) who commented he was having difficulty in keeping the
protective dressing on because of thick body hair preventing the adhesive
from sticking. While this was mentioned in levity, the occurrence of a
vaccinial opthalmic infection in a contact of a recent vaccinee should
serve as a reminder of the need to ensure that protective dressings are on
securely, and in the case of hirsute individuals, shaving the vaccination
site and surrounding area to permit a protective dressing to adhere might
be considered. - Mod.MPP]