PEDIATRICS Vol. 110 No. 4 October 2002, pp. 841-845
AMERICAN ACADEMY OF PEDIATRICS
Smallpox Vaccine
Committee on Infectious Diseases
After an extensive worldwide eradication program, the last
nonlaboratorycase of smallpox occurred in 1977 in Somalia. In 1972,
routinesmallpox immunization was discontinued in the United States,and since 1983, vaccine production has been halted. Stockpiled
vaccine has been used only for laboratory researchers workingon
orthopoxviruses. In recent years, there has been concernthat
smallpox virus stocks may be in the hands of bioterrorists,and this
concern has been heightened by the terrorist attackon the World
Trade Center and the Pentagon on September 11,2001. Because most of
the population is considered to be nonimmune,there is debate as to
whether smallpox immunization should beresumed. This statement
reviews the current status of smallpoxvaccine, the adverse effects
that were associated with smallpoxvaccine in the past, and the major
proposals for vaccine use.The statement provides the rationale for a
policy based on theso-called ring vaccination strategy recommended
by the Centersfor Disease Control and Prevention, in which cases of
smallpoxare rapidly identified, infected individuals are isolated,
andcontacts of the infected individuals as well as their contactsare immunized immediately.
Abbreviations: HIV, human immunodeficiency virus CDC,
Centers for Disease Control and Prevention VIG, vaccinia immune globulin AAP,
American Academy of Pediatrics
ALL INFORMATION, DATA, AND
MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"