Smallpox immunization in the United States

Abstract

The USA are now in an interim period regarding smallpox prophylaxis. Although, the areas of the globe where smallpox is endemic are gradually being diminished, there is an increased chance of exposure as a result of increasing travel to and from smallpox endemic regions. A number of changes in vaccination practice are indicated to avoid unnecessary complications. Reducing the risk of vaccinia complications by a more gentle vaccination technique, and the recognition (and legal acceptance) of additional medical contraindications will help to eliminate many of the opportunities for complications to develop. It is likely that either modified live vaccinia virus or a killed product may come available for prevaccination in an effort to make possible safe immunization of those who require it.