Updated December 20, 2002

Over the next two years, smallpox vaccine will gradually be made available to the entire US population to guard against a potential bioterrorist attack. But the promise of protection carries risk for a small proportion of those who receive the vaccine and raises questions for clinicians who will both receive and administer it. Medscape's editors have developed this collection of reports to help identify who is at risk; how to decide whether to get the vaccine; how to take care of patients postvaccination; and the subsequent implications for staffing if emergency workers and other clinicians receive the vaccine within the same 30 days.

Reports and Interviews

US Starts to Focus on Details of Initial Smallpox Vaccination Rollout
Federal officials on Thursday revealed how they propose to vaccinate Americans against smallpox, noting that it is a high-stakes challenge that puts the public's health and the public health system's credibility at risk.

Alternative Smallpox Strategies: A Newsmaker Interview With Thomas Mack, MD, MPH
Mass vaccination of healthcare workers and hospitalization of infected persons may do more harm than good.

Real Risks of Smallpox Debated
Some experts find it hard to justify mass smallpox vaccination without evidence of an impending bioterrorist attack, while others are in favor of leaving the choice to an informed public.

Bush Unveils Smallpox Vaccination Plan
Experts debate the benefits and risks of widespread vaccination versus those of waiting for exposure.

CDC Fact Sheets

Smallpox (Vaccinia) Vaccine Contraindications
If a potential vaccinee or someone they live with has any of these conditions, that person should not receive the smallpox vaccine unless they have been exposed to the smallpox virus.

Adverse Reactions Following Smallpox Vaccination
Most adverse reactions are totally benign, but may be alarming in appearance; some are serious, but treatable; a few, which rarely occur, are serious, life threatening and can be fatal.

Medical Management of Smallpox (Vaccinia) Vaccine Adverse Reactions
There are two medications that may help persons who have certain serious reactions to the smallpox vaccine; vaccinia immune globulin (VIG) and cidofovir.

Instant Polls

Do you plan to get vaccinated for smallpox when the vaccine is available? Vote or view what your colleagues say they'll do.

Related Medscape Resource Centers

Bioterrorism

Related Links

Centers for Disease Control and Prevention: Bioterrorism

Federal Emergency Management Agency

Food and Drug Administration: Bioterrorism

Medical Management of Biological Casualties Handbook