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Clin Infect Dis 2003;37(2):241-250
Because smallpox could be a factor in bioterrorism, the United States has provided guidelines for smallpox vaccination of certain members of the population, including health care workers and first responders, as well as military personnel. A plan for more extensive vaccination, if it is needed in the event of a bioterrorist attack, is being developed under the aegis of the Centers for Disease Control and Prevention. The characteristics of smallpox vaccine, the technique of administration, and the expected reactions to primary vaccination and revaccination are outlined in this article.
"Smallpox in nature was eliminated from the world in 1977 by a concerted effort organized by the World Health Organization. The last cases occurred in persons who acquired smallpox from an adjacent laboratory source in Birmingham, England, in 1978. Smallpox vaccination was discontinued in the United States in 1972, except for vaccination of a few laboratory workers and, until 1983, military personnel. The terrorist attack on the World Trade Center in New York City in 2001 caused the U.S. government to reevaluate the possibility of the reintroduction of smallpox. There is now renewed interest in smallpox vaccine and vaccination. This article reviews information about the vaccine, its application, and expected normal reactions. A second article addresses the spectrum of adverse events that could occur after vaccination.