Emergency Preparedness

Kern Medical Bioterrorism Response Guide Section 2-C-1 – Smallpox

Vaccine Contraindications The risk of vaccination should be weighed against the likelihood of acquiring smallpox. To decrease the risk of vaccine complications, newly vaccinated household members who live with persons who have contraindications to vaccination (defined below) should consider removing themselves from the household until the vaccination site has completely healed. Unless concurrently assessed by a physician, vaccination should not be administered to exposed persons or their household contacts if there is a history of any of the following conditions: ? Current or past history of eczema even if the condition is mild or not presently active; ? Persons with other acute or chronic skin conditions such as impetigo, atopic dermatitis, contact dermatitis, varicella zoster, or other skin conditions ? Pregnancy (all trimesters) ? Persons with immunodeficient conditions such as current treatment for cancer (chemo/radiation therapy), receiving large doses of corticosteroids; or altered immune systems such agammaglobulinemia ? HIV infection or AIDS ? Allergies to polymixin B, streptomycin, tetracycline, neomycin Vaccine Administration The vaccine is administered using a special needle and multiple-skin punctures. The skin is punctured 15 times and a small amount of blood will be seen at the puncture site. Vaccine Response The vaccination is successful if the puncture site has a visible pimple with an area of redness surrounding the pimple within 2 – 5 days after vaccination. The pimple will become bigger over the next several days and eventually a dark colored scab will form . Primary vaccination may be associated with fever for a few days and enlarged, tender lymph nodes in the axilla of the vaccinated arm. Major or Primary (first) Vaccine Response ? Days 2 - 5: A red papule (pimple) is visible at the vaccination site; the papule progresses to a fluid-filled vesicle then to a pustule over the next fewdays; ? Days 8 -10: The pustule reaches maximum size and contains turbid (cloudy) fluid (pus) surrounded by a red area. The red area may get bigger over the next 3 days. ? Days 14 –21:The pustule dries, forms a scab, and eventually falls off .

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