Vaccine Adverse Events
The smallpox vaccine is generally safe and effective, but some people do experience side effects and adverse reactions. Severe adverse reactions are more common in people who are being vaccinated for the first time and among young children (<5 years of age).
Inadvertent autoinoculation is the unintentional transfer of vaccinia virus from the vaccination site to another place on the vaccinee’s body. Vaccinees can transfer vaccinia to their hands or fomites. The most common sites are the eye and surrounding orbit (ocular vaccinia), followed by the face, nose, mouth, lips, genitalia, and anus.
A vaccinee can also spread vaccinia virus from the vaccination site (or other lesions distant from the vaccination site) to close contacts through direct contact or through other vectors such as clothing, bedding, or bandages contaminated by vaccinia virus. Viral shedding can occur until the scab detaches from the vaccination site (or any distant lesions), revealing healthy skin underneath. Infection through contact transmission can result in the same adverse events observed after smallpox vaccination.
A vaccinee can also spread vaccinia virus from the vaccination site (or other lesions distant from the vaccination site) to close contacts through direct contact or through other vectors such as clothing, bedding, or bandages contaminated by vaccinia virus.
Eczema vaccinatum is a localized or systemic spread of vaccinia virus.
Cardiac Adverse Events,
Reports of inflammatory disease of the myocardium, pericardium, or both after smallpox vaccination suggest an association between smallpox vaccination with the New York City Board of Health vaccinia strain and myo/pericarditis.
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