Vaccine And Immunoglobulin Administration
Dose, route of administration and schedule
Smallpox vaccine is administered by scarification into the epidermis, usually in the deltoid area of the non-dominant arm, by using the multiple-puncture technique with a bifurcated needle, packaged with the vaccine and diluent. According to the product labelling, 15 punctures are recommended for vaccination. A trace of blood should appear at the vaccination site after 15 to 20 seconds if no trace of blood is visible, additional insertions should be made by using the same bifurcated needle without reinserting the needle into the vaccine vial. If alcohol is used to cleanse the skin before immunization, the skin must be allowed to dry thoroughly before the vaccine is administered, to prevent inactivation of the vaccine by alcohol.
Other methods of administration, such as multiple pressure method are possible in case bifurcated needles are not readily available. Refer to the product label for detailed instructions.
Health care workers providing direct patient care should keep their vaccination sites covered with gauze in combination with a semipermeable membrane dressing to absorb exudates and to provide a barrier for containment of vaccinia virus to minimize the risk of transmission the dressing should also be covered by a layer of clothing. Similar precautions should be used for vaccinated persons in close contact with children or other persons at high risk of serious complications of vaccinia.
Booster doses and re-immunization
Data Quality & Definitions
The origin of the naming of smallpox and the variola virusThe name of smallpox originates from a common confusion with syphilis in 15th century France. The diseases shared similar symptoms even though syphilis was caused by spirochaete bacteria and smallpox by the variola virus. Syphilis had already been known as variola, so smallpox became known as la petite vérole. Petite is French for small so the disease became known as smallpox in English.
The name of the variola virus, in turn, can be derived from the Latin words varus or varius which derive from smallpoxs symptoms described above.40
The variola virus family treeThe variola virus is a member of the so-called orthopoxvirus family, whose other members are the vaccinia, cowpox and monkeypox viruses.41
This is important as Jenners vaccine used the cowpox virus, a much milder and not lethal disease, to protect humans against smallpox. The variola virus is the familys only virus that exclusively infects humans.
The variola virus consists of two strands, known as the variola major and variola minor viruses. Infections of the variola major strand led to a patients death in approximately 30% of cases, whereas the variola minor virus proved lethal in only less 1% of infections.42
Standard epidemiological definitions
Eradication is the permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts.43
Smallpox endemic characterisation
Can Vaccines Stop A Smallpox Outbreak
After the September 11, 2001, terrorist attacks and the anthrax scare that same year, the U.S. government took the precaution of asking several companies to begin making smallpox vaccine again. Today, there’s enough vaccine on hand to protect the American people in the event of a smallpox outbreak.
Public health officials have a rapid response plan ready to vaccinate anyone exposed to the disease, as well as people who come into contact with them. So although a person doesn’t need to get vaccinated at the moment, the vaccine is there in case it’s needed.
Because the vaccine can stop the spread of the disease, experts believe it’s unlikely that terrorists will go to the trouble of producing and using smallpox as a biological weapon it would take too long and have little effect.
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Who Should Not Get The Smallpox Vaccine
Talk to your healthcare provider about any of the following. He or she may recommend the vaccine during an outbreak.
- Children younger than 16 years
- Anyone who had an allergic reaction to the vaccine or to the antibiotics neomycin, streptomycin, polymyxin B, or chlortetracycline
- A pregnant female
- Anyone with immune system problems, leukemia, lymphoma, cancer, HIV, or AIDS
- Anyone who had a bone marrow or organ transplant
- Anyone who uses medicines that weaken the immune system, such as steroids, radiation, or cancer medicines
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A Little Help From A Cow
Variolation remained an important practice throughout Asia and Africa, reaching Europe and the New World colonies by the early 18th century, where it was first used to stop the Boston smallpox epidemic of 1721.
In the late 18th century, English physician Edward Jenner arrived at the observation that dairymaids were protected against smallpox because of their contact with cowpox, a now rare, self-limiting disease transmitted through lesions on the udder and teats to humans. Jenner postulated that to confer biological protection, much like with variolation, cowpox could be deliberately acquired through some sort of inoculation.
In May 1796, Jenner collected pus from the fresh scabs of a young dairymaid recently infected with cowpox and injected it into a 8-year-old boy. While testing what was essentially a live vaccine a vaccine containing a weakened or attenuated form of a virus on a human subject is ethically disconcerting, the young boy did not develop smallpox when injected with it six weeks later.
Vaccination, as the practice eventually came to be known, from the Latin for cow or vacca, was considered a groundbreaking medical discovery, gaining acceptance throughout Europe and paving the road for future vaccines. In the U.S., Jennerian vaccination was encouraged partly thanks to Thomas Jefferson, who conducted small vaccine trials himself and made it one of the new nation’s first health priorities when elected president in 1801.
What Is The Outlook For People With Smallpox
Before 1980, around 30% of people with smallpox died from the disease. Most people who survived smallpox had severe scarring after scabs from the blisters fell off. Smallpox also caused blindness when ulcers formed on the eyes.
If someone got smallpox today, antiviral drugs would likely decrease the severity of the illness. But since researchers developed these drugs after smallpox was wiped out, theyve never used them to treat a person with smallpox. Still, international health authorities are prepared to respond quickly to keep people safe if smallpox ever comes back.
You’re Not Just Protecting Yourself
Many vaccines work by creating community immunity . When most people in a community have been immunized against a disease, the chance of an outbreak of that disease is greatly reduced.
The vaccine protects you, but it also protects those around you, like little babies who are too young for vaccines, people fighting illnesses such as cancer, and the elderly.
How Common Is Smallpox
There havent been any confirmed cases of smallpox since it was wiped out. Before that, smallpox was a life-threatening disease. Millions of people got smallpox every year. Up to 30% of people died of their illness. Death was due to systemic shock and toximemia . Smallpox is very contagious disease, with secondary attacks affecting up to 80% of house hold contacts. Often, people who survived the disease had long-term problems, such as blindness and severe scarring.
Researchers believe that the disease first appeared in the third century. For thousands of years, smallpox spread throughout the world. In the 1960s, the WHO led a worldwide effort to eliminate smallpox.
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Vaccines Are As Easy As One Two Three
It’s true that needles may hurt for a second or two. But hey, isn’t the pain worth it for protection from a disease that could hurt you a whole lot more?
You know vaccination is one of the best steps you can take to protect your health, but it’s a good idea to think of getting it in terms of three steps.
Number Of Smallpox Cases
Smallpox cases by country
The chart depicts the number of smallpox cases by country, for most countries dating 1920 until 1977. Here we see that by the time the World Health Organization launched its Intensified Smallpox Eradication Program in 1966, most countries in Western Europe and North America had almost eliminated smallpox whilst the countries across South America, Africa and Asia, especially India, still recorded very large numbers .
Global decline of smallpox
Global data on the number of smallpox cases is shown in the chart. Shown here is the number of reported smallpox cases worldwide from 1920 until the last case in 1977. Just the reported number of smallpox cases between 1920 and 1978 already amounted to 11.6 million cases and that number was certainly smaller than the actual number of cases, although we do not know by how much. Even though smallpox had a high visibility and should therefore be relatively easy to document, the lack of an international organization dedicated to global health means the number of reported cases is probably substantially lower than the true number of cases. Crosby estimates that in 1967 10-15 million people were still being infected with smallpox every year while the chart on the reported cases below indicates only 132,000 for that same year.17
The reasons and extent of discrepancies between reported and estimated cases are discussed in our section on Data Quality.
Smallpox decline by region
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A Look At Each Vaccine: Smallpox Vaccine
When Cortez’s army brought smallpox from Europe to the Western Hemisphere, about 4 million Aztecs died from the disease. In the early part of the 18th century, Boston, a city of 10,000 people, suffered an epidemic of smallpox 5,000 people were infected and 800 died from the disease. Indeed, smallpox has probably killed more people in the history of the world than all other infectious diseases combined! About 300 million people have died from smallpox. However, because of the smallpox vaccine, first developed in the late 1700s, smallpox was eradicated. Eradicated means that it was completely eliminated from the face of the earth. Smallpox was declared to be eradicated by the World Health Organization in 1980.
How Can You Prevent It
People who have survived smallpox cannot get it again.
Also, there is a smallpox vaccination. It has vaccinia virus in it, which is like the smallpox virus but safer. If you get the shot before you’ve been exposed to smallpox, it will likely protect you for at least 3 to 5 years. And having a second shot later can protect you for an even longer period of time.
The shot works even if you don’t get it in advance. Most people who get the smallpox shot within 3 days after they’ve been exposed to the virus will have no symptoms or will have symptoms that aren’t as severe. Getting a shot 4 to 7 days after exposure may also help.
People who have very close contact with a person who has gotten a smallpox vaccine can get an infection from the virus used in the vaccine. The infection usually causes a and is not smallpox. So the site where the smallpox vaccine was given should be covered until the scab falls off.
In the past, when a smallpox infection was diagnosed, infected people were kept away from others to prevent the spread of infection. Everyone who might have been exposed to the virus was then vaccinated. This practice, called ring vaccination, played a key role in wiping out smallpox. Many experts think it would be better to carry out ring vaccination before mass vaccination if there were a case today.
Since the September 2001 terrorist attacks on the U.S., more vaccine has been made. The U.S. government has enough smallpox vaccine for all Americans in case of an outbreak.
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Smallpox Vaccination Procedure : Smallpox
It’s a great reminder that. Learn about the smallpox vaccine. For this reason, the vaccination is of. Most, but not all, also apply t. Contraindications to vaccination in the absence of a smallpox outbreak, do not give the smallpox vaccine to anyone with the contraindications described below. Shingles is a condition that you can develop if you’ve had chickenpox before.
What Are The Signs Of A Smallpox Infection
If someone becomes infected with smallpox, it may take anywhere from 7 to 17 days for symptoms to develop. At first a person may have flu-like symptoms such as high fever, tiredness, headaches, and backaches.
Within 2 to 3 days after symptoms start, a rash develops that typically affects the face, legs, and arms. It starts with red marks that become filled with pus and crust over. Scabs develop and then fall off after about 3 to 4 weeks.
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Could Smallpox Come Back
Scientists saved some samples of the variola virus so they could continue to research vaccines and treatments. Only two locations in the world have these virus samples. Theyre secured at the Centers for Disease Control and Prevention in Atlanta and the State Research Center of Virology and Biotechnology in Russia.
Since smallpox no longer occurs naturally, public health officials are only concerned about it spreading as a result of biological warfare. There hasnt been any immediate threat of terrorists using smallpox as a weapon. But scientists are prepared to respond if someone weaponized smallpox. The CDC has created enough smallpox vaccine to protect everyone in the United States if the virus does resurface.
Getting The Smallpox Vaccine
The smallpox vaccine is given by a special technique. It is not administered as a shot in the way that most other vaccines are. It is given using a two-pronged needle that is dipped into the vaccine solution. When removed, the needle holds a droplet of the vaccine. The needle is used to prick the skin a number of times in a few seconds. The pricking is not deep, but it will cause a sore spot and one or two drops of blood to form. The vaccine usually is given in the upper arm.
If the vaccination is successful, a red and itchy lesion develops at the vaccine site in 3 to 4 days. In the first week, the lesion becomes a large blister, fills with pus, and begins to drain. During the second week, the lesion begins to dry and a scab forms. The scab falls off in the third week, leaving a small scar.
People who are being vaccinated for the first time have a stronger reaction than those who are being revaccinated. The following pictures show the progression of the site where the vaccine is given in someone who has not gotten the vaccine before.
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Efficacy Effectiveness And Immunogenicity
In the early 1970s before smallpox was eradicated, a retrospective study conducted in West Pakistan showed a mortality rate of 52% among those who had never been vaccinated, 1.7% among those who had been vaccinated within 10 years, and 11% among those who had been vaccinated 20 or more years earlier.
The specific mechanisms that result in immunity to smallpox following vaccination have not been well characterized. Studies conducted in the 1970s suggest that both antibody and cell-mediated immunity are stimulated by smallpox vaccination. A more recent study showed that more than 95% of primary vaccinees had detectable neutralizing antibody within 1 to 2 weeks after immunization and strong increases in vaccinia-specific CD8+ cytotoxic T lymphocytes and interferon-gamma-producing T cells.
There’s A Vaccine For Hpv
Human papillomavirus is a common sexually transmitted virus and it can cause cancer. You can have HPV and pass it on without knowing it. The virus is spread by skin-to-skin or oral contact, so you don’t have to have intercourse to get it, and using a condom doesn’t fully protect you from the virus.
There are many types of HPV. Some cause warts on the genitals of both males and females. And the really bad news is that HPV can cause cancers, like cervical, vaginal, vulvar, penile, anal, throat, tongue and others!
Now for the good news! You can protect yourself against many of the types of HPV that cause warts and cancers by getting the HPV vaccine. The sooner you get it the better.
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