Adverse Reactions Following Smallpox Vaccination

Description

Following vaccination against smallpox, a variety of adverse reactions may occur. These may range from mild to severe. In severe reactions vaccinia immunoglobulin (VIG) may be indicated.

NOTE: I am not sure what the availability of vaccinia immunoglobulin is, but it probably is hard to get and fairly expensive. CDC should be contacted for information on availability and use.

Type of Adverse Reaction	Severity
fever	mild to moderate
inadvertent autoinoculation (face, eyelid, nose, mouth, genitalia, rectum)	mild to moderate
erythematous or urticarial rashes	mild to moderate
bullous erythema multiforme (Stevens- Johnson syndrome)	moderate to severe
eczema vaccinatum	moderate to severe
generalized vaccinia	moderate to severe
progressive vaccinia (vaccinia necrosum, vaccinia gangrenosum)	moderate to severe
postvaccinial encephalitis	moderate to severe
vaccinial keratitis	moderate to severe

Indications for vaccinia immunoglobulin:

(1) possibly ocular autoinoculation (contraindicated with keratitis)

(2) severe eczema vaccinatum

(3) severe generalized vaccinia

(4) generalized vaccinia in a patient with a severe underlying illness

(5) severe progressive vaccinia (vaccinia necrosum)

Contraindications for vaccinia immunoglobulin:

(1) vaccinia keratitis (infection of the cornea)

(2) allergy to components

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Adverse Reactions Following Smallpox Vaccination

Description

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