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What should I discuss with my healthcare provider before receiving smallpox vaccine (Dryvax)?

You should not receive this vaccine if you have ever had a life-threatening allergic reaction to any vaccine containing vaccinia virus, or if you have:

• a heart condition such as coronary artery disease, congestive heart failure, or chest pain (angina);
• a history of heart attack, stroke, or"mini-stroke";
• a weak immune system caused by disease (such as cancer, HIV, or AIDS), or by taking certain medicines such as steroids;
• a skin wound, burn, infection such as impetigo or shingles (herpes zoster), or disorder such as eczema (atopic dermatitis);
• an allergy to antibiotics such as neomycin, polymyxin B, streptomycin, or tetracycline.
• if someone in your household has a weak immune system or a skin disorder such as eczema;
• if you are pregnant or breast-feeding; or
• if you have received cancer chemotherapy or radiation treatment in the past 3 months.

Before receiving this vaccine, tell your doctor if you are allergic to any drugs, or if you have:

• a chronic disease such as asthma or other breathing disorder, diabetes, kidney disease, or blood cell disorders such as anemia;
• an autoimmune disorder such as multiple sclerosis, rheumatoid arthritis, or systemic lupus erythematosus;
• an allergy to latex rubber;
• if you have recently used a steroid eye drop; or
• if you have at least 3 heart risk factors such as smoking, diabetes, high cholesterol, high blood pressure, or a family history of heart disease in a person younger than 50.

You can still receive this vaccine if you have a cold or fever. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.

How is this vaccine given (Dryvax)?

This vaccine is not given with a needle and syringe, as most other vaccines are. Instead, the smallpox vaccine is given using a two-pronged needle that is dipped into the vaccine solution and then used to prick the skin several times to deliver the vaccine into the shallow layers of skin. These needle sticks are not deep, but they will cause some soreness and minor bleeding.

Smallpox vaccine usually is given in the skin of your upper arm. You will receive this injection in a doctor's office or other clinic setting.

Within 3 to 4 days after receiving this vaccine, you should see a small red bump on your skin where the needle was placed. This bump may itch and it will gradually grow larger and form a blister filled with pus that will eventually drain. During the second week the blister should dry up and form a scab. After the scab falls off during the third or fourth week, you will most likely have a small scar.

Smallpox vaccine contains a live form of the virus. This means that after you receive the vaccine and until your scab falls off, your vaccination sore will be "contagious" and could spread the virus to anything or anyone who touches it.

A vaccination sore can transfer smallpox virus to bandages, clothing, bedding, towels, wash cloths, or furniture.

Keep your vaccination sore covered at all times with a gauze bandage, especially while the sore is draining pus. This bandage will provide a barrier to protect against spreading the virus to other people or to other parts of your own body. Change your bandage at least once a day, or as needed to keep the sore clean and dry.

Use a gauze bandage held in place with first aid tape. The bandage should allow air to flow through it to keep your vaccination sore dry. Do not apply ointments or salves to the sore. Use a waterproof bandage to cover the sore while you are bathing. Apply a dry gauze bandage after bathing. Be sure to wash your hands with soap and hot water after changing your bandage.

Throw away used bandages in a sealed plastic bag placed in a garbage can that children and pets cannot reach. Do not allow anyone else to handle your used bandages.

Always wash your hands thoroughly with soap and hot water after touching your vaccination sore, changing your bandages, or handling clothing, towels, or other fabrics that have come into contact with your sore. You may also use an alcohol-based hand rub such as Purell.

The virus can also spread to other parts of your body that come into contact with your vaccination sore. Avoid touching the sore and then touching other parts of your body (especially your eyes) until you have washed your hands.

Wear a shirt at all times to cover your vaccination sore while it is healing. If you share a bed with someone, wear a shirt or pajamas to keep from spreading the virus to your bedding or to the other person.

Do not share towels, clothing, or other personal items while your vaccination sore is healing. Use a separate laundry basket or hamper for your clothing, towels, and bedding. All of your laundry should be washed in hot water with detergent and bleach (if possible) to kill any smallpox virus remaining on these items.

Get medical help if someone in your household shows any symptoms of smallpox, such as skin rash, fever, headache, or body aches. These may be signs that the virus has spread to that person or to something in the household that the person has touched.

When your scab falls off, place it in a sealed plastic bag and throw it away. Wash your hands with soap and hot water afterward.

This vaccine can cause false results on a skin test for tuberculosis. Tell any doctor who treats you if you have received a smallpox vaccine within the past 4 to 6 weeks.

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