Complications of Smallpox Vaccination, 1968: Results of Ten Statewide Surveys

Lane, John; Ruben, Frederick L.; Neff, John M.; Millar, J. Donald

doi:10.1093/infdis/122.4.303

Cited by 280 publications

(22 citation statements)

References 6 publications

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“…During the same 2004-2014 period, no reports of preventable vaccine-associated serious adverse events (e.g., eczema vaccinatum, progressive vaccinia, or contact transmission) were documented among laboratory and health care personnel at risk for occupational exposure who had been vaccinated with smallpox vaccine. Furthermore, data from U.S. military personnel and civilian first responders vaccinated during smallpox vaccination campaigns that were initiated in 2002 indicate that the incidence of serious adverse events overall was lower than previously reported in 1968 (14)(15)(16). Although serious adverse events have occurred, this decrease in incidence is likely attributable to more stringent prevaccination screening procedures to identify persons who should not receive the vaccine, to increased use of protective bandages to cover the vaccination site, and to enhanced education of vaccinees compared with the routine vaccination practices in place in the 1960s.…”

Section: Rationale and Evidencementioning

confidence: 87%

Use of Vaccinia Virus Smallpox Vaccine in Laboratory and Health Care Personnel at Risk for Occupational Exposure to Orthopoxviruses — Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2015

Petersen¹,

Harms²,

Reynolds³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

106

110

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Section: Rationale and Evidencementioning

confidence: 87%

Use of Vaccinia Virus Smallpox Vaccine in Laboratory and Health Care Personnel at Risk for Occupational Exposure to Orthopoxviruses — Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2015

Petersen¹,

Harms²,

Reynolds³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

106

110

View full text Add to dashboard Cite

“…Vaccinia vaccination was the cornerstone of the smallpox eradication campaign, and much of the world was vaccinated during that effort. However, serious complications are associated with vaccinia, particularly in immunocompromised individuals, where the vaccination can lead to serious complications including death (Lane et al, 1970; Thomas et al, 2008). To control an outbreak today, vaccination of at risk individuals would be enacted.…”

Section: Introductionmentioning

confidence: 99%

Inhalational monkeypox virus infection in cynomolgus macaques

Barnewall¹,

Fisher²,

Robertson³

et al. 2012

Front. Cell. Inf. Microbio.

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An inhalation exposure system was characterized to deliver aerosolized monkeypox virus (MPXV), and a non-human primate (NHP) inhalation monkeypox model was developed in cynomolgus macaques. A head-only aerosol exposure system was characterized, and two sampling methods were evaluated: liquid impingement via an impinger and impaction via a gelatin filter. The aerosol concentrations obtained with the gelatin filter and impinger were virtually identical, indicating that either method is acceptable for sampling aerosols containing MPXV. The mass median aerodynamic diameter (MMAD) for individual aerosol tests in the aerosol system characterization and the NHP study ranged from 1.08 to 1.15 μm, indicating that the aerosol particles were of a sufficient size to reach the alveoli. Six cynomolgus macaques (four male and two female) were used on study. The animals were aerosol exposed with MPXV and received doses between 2.51 × 104 to 9.28 × 105 plaque forming units (PFUs) inhaled. Four of the six animals died or were euthanized due to their moribund conditions. Both animals that received the lowest exposure doses survived to the end of the observation period. The inhalation LD50 was determined to be approximately 7.8 × 104 pfu inhaled. These data demonstrate that an inhalation MPXV infection model has been developed in the cynomolgus macaque with disease course and lethal dose similar to previously published data.

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“…Since EV and other adverse reactions to smallpox vaccination occur most frequently in children [8,9,10], we compared the course of viral infection in ‘young’ (age approx. 4 weeks) and ‘old’ (age approx.…”

Section: Discussionmentioning

confidence: 99%

“…Most often this type of reaction is limited to the skin, but in some cases the reaction may be systemic with infection of internal organs. EV is most commonly seen among children aged 1–5 years old, suggesting that the age of the host is a major determinant of outcome [8,9,10]. It is unclear why this severe, life-threatening reaction to smallpox vaccination is primarily limited to this group of allergic, young patients.…”

Section: Introductionmentioning

confidence: 99%

Susceptibility to Vaccinia Virus Infection and Spread in Mice Is Determined by Age at Infection, Allergen Sensitization and Mast Cell Status

Domenico

Lucas

Fujita

et al. 2012

Int Arch Allergy Immunol

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Background: Patients, especially young children, with atopic dermatitis are at an increased risk of developing eczema vaccinatum, a severe reaction to the smallpox vaccine, either through direct vaccination or indirect contact with a person recently vaccinated. Methods: Using a mouse model of infection, the severity of vaccinia-induced lesions was assessed from their appearance and viral DNA content. The response to vaccinia inoculation was assessed in young and adult mice, allergen-sensitized mice, and in mast cell-deficient mice. Results: Young age, sensitization to an allergen prior to infection, and a mast cell deficit, accomplished by using mast cell-deficient mice, resulted in more severe viral lesions at the site of inoculation, according to lesion appearance and viral DNA content. All three factors combined demonstrated maximal susceptibility, characterized by the severity of primary lesions and the development of secondary (satellite) lesions, as occurs in eczema vaccinatum in humans. Resistance to the appearance of satellite lesions could be restored by adoptive transfer of bone marrow-derived mast cells from either wild-type or cathelicidin-related antimicrobial peptide-deficient mice. Primary lesions were more severe following the latter transfer, indicating that cathelicidin-related antimicrobial peptide does contribute to the protective activity of mast cells against infection. Conclusions: The combination of young age, allergen sensitization and a mast cell deficit resulted in the most severe lesions, including satellite lesions. Understanding the factors determining the relative resistance/sensitivity to vaccinia virus will aid in the development of strategies for preventing and treating adverse reactions which can occur after smallpox vaccination.

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Complications of Smallpox Vaccination, 1968: Results of Ten Statewide Surveys

Cited by 280 publications

References 6 publications

Use of Vaccinia Virus Smallpox Vaccine in Laboratory and Health Care Personnel at Risk for Occupational Exposure to Orthopoxviruses — Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2015

Use of Vaccinia Virus Smallpox Vaccine in Laboratory and Health Care Personnel at Risk for Occupational Exposure to Orthopoxviruses — Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2015

Inhalational monkeypox virus infection in cynomolgus macaques

Susceptibility to Vaccinia Virus Infection and Spread in Mice Is Determined by Age at Infection, Allergen Sensitization and Mast Cell Status

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