Emergency Preparedness

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

Previously Vaccinated Response

? Revaccination is considered successful if a pustular lesion is present or anarea of definite induration or congestion surrounding the scab is visible upon examination 6 - 8 days after revaccination. If the response peaks at 48 hours (hypersensitivity reaction), the person should be re-vaccinated. Equivocal Reaction ? Equivocal reactions are defined as all responses other than major reactions. If an equivocal reaction is observed, vaccination procedures should be checked and the vaccination repeated using vaccine from a different vial or from a different lot, if available. Difficulty in determining if the reaction was blunted could be caused by immunity, insufficient potent vaccine, or vaccination technique failure. If the repeat vaccination using vaccine from a different vial or lot fails to elicit a major reaction providers should consult with the local health officer before attempting another vaccination. Vaccination Site Care Complications associated with smallpox vaccination can be reduced when careful site care is practiced from the time vaccination is administered until the scab falls off the vaccination site. ? Wash hands with soap and water before and after any contact with the vaccination site (e.g. dressing change, accidental scratching) or contact with any fluid or pus that might seep through the dressing. Do not touch the vaccination site (fluid or pus) with items such as cloth towels that may be used by another householdmember. ? Cover the vaccination site loosely with gauze dressing at all times. Secure the gauze loosely with tape. Occlusive dressings should not be used routinely because it may cause maceration at the vaccination site. ? Soiled dressings should be sealed in a plastic bag before disposal. If the scab has fallen off the skin, the scab should also be sealed in a plastic bag. ? Keep the vaccination site dry at all times. When bathing, place gauze dressing over the vaccination site and then cover the site with a watertight dressing. To make a watertight dressing, cut a piece of plastic (Saran (R) ) wrap large enough to extend 2 - 3 inches beyond the vesicle. Place the wrap over the gauze and secure with tape. Remove the plastic wrap after bathing and apply clean, dry, gauze dressing, if necessary. ? Clothes that become soiled with fluid or pus from the drainage site should be removed and washed in hot water. ? Report all vaccination complications to a health care worker (nurse or physician). ? Monitor your temperature daily. If a fever occurs, take Tylenol (R) as directed on the package label.

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