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Post-Vaccination Care " After vaccination, it is important:to follow care instructions for the site of the vaccine. Because the virus is live, it can spread to other partsof the body, or to other people. The vaccinia virus (the live virus in the smallpox vaccine) may cause rash, fever, and head and body aches. Tn certain groups of people (see the section "Smallpox Vaccine Safety/" in this fact sheet), complications from the vaccinia virus can be severe. Benefit of Vaccine Followi~_g Exposure Vaccination within 3 days of exposure will prevent or significantly lessen the severity of smallpox symptoms in the vast majority d.t' people. Vaccination 4 to 7 days after exposure likely offers some protection from disease or may ~odify the severity of disease. Smallpox Vaccine Safety The smallpox vaccine is the besl~rotection you can get if you are exposed to the smallpox virus. Anyone directly exposed to smallpox, regardless of health status, would be offered the smallpox vaccine because the risks associated with smallp0.x disease are far greater than those posed by the vaccine. There are side effects and risks ~ssociated with the smallpox vaccine. Most people experience normal, usually mild reactions that inclu~t~ a sore arm, fever, and body aches. However, other people experience reactions ranging from serious t~ life-threatening. People most likely to have serious side effects are: people who have had, even once:- skin conditions (especially eczema or atopic dermatitis) and people with weakened immune systems, such as those who have received a transplant, are HTV positive, are receiving treatment for cancer, or are currently taking medications (like steroids) that suppress the immune system. Tn addition, pregnant wC~nen should not get the vaccine because of the risk it poses to the fetus. Women who are breastfeeding should not get the vaccine. Children younger than 12 months of age should not get the vaccine. Also, the AdVisory Committee on Tmmunization Practices (ACTP) advises against non- emergency use of smallpox vaccine in children younger than 18 years of age. Tn addition, those allergic to the vaccine or any of its components should not receive the vaccine. In the past, about 1,000 people ~r every I million people vaccinated for the first time experienced reactions that, while not life-threatening, were serious. These reactions included a toxic or allergic reaction at the site of the vaccination (er~hema multiforme), spread of the vaccinia virus to other parts of the body and to other individuals (inBdvertent inoculation), and spread of the vaccinia virus to other parts of the body through the blood (generalized vaccinia). These types of reactions may require medical attention. In the past, between :~4 and 52 people out of every I million people vaccinated for the first time experienced potentially life-thre~.,ening reactions to the vaccine. Based on past experience, it is estimated that 1 or 2 people in I million wl~D receive the vaccine may die as a result. Careful screening of potential vaccine recipients is essential to ~nsure that those at increased risk do not receive the vaccine. Smallpox Vaccine Availabil~y Routine smallpox vaccination among the American public stopped in 1972 after the disease was eradicated in the United States. Until recenUy, the U.S. government provided the vaccine only to a few hundred scientists and medical profession;~ls working with smallpox and similar viruses in a research setting. After the events of September a~l October, 2001, however, the U.S. government took further actions to improve its level of preparednes~_--:against terrorism. One of many such measures--designed specifically to prepare for an intentional releas~of the sma pox v rus--included updating and releasing a smallpox response plan. Tn addition, the U~. government ordered production of enough smallpox vaccine to immunize the American public inli:he event of a smallpox outbreak. Right now, the U.S. government has access to enough smallpox vacci~,e to effectively respond to a smallpox outbreak in the United States. For more information, visit www.cdc.eov/smallpox, or call the CDC public response hotline at (888) 246-2675 (~nglish), (888) 246-2857 (EspaQol), or (866) 874-2646 (TI-Y) December 9, 2002 DEPARTI~ENT OF HEALTH AND HUMAN SERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION SAFER · HEALTHIER ° PEOPLE'"