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
Specialty: Infectious Diseases, Pharmacology, clinical