In
addition, it is known that individuals exposed to smallpox can be protected
against illness if they are vaccinated within a few days after exposure. Therefore,
we have no need to expose the entire U.S. population to the risks of smallpox
vaccination with the current vaccine.
Smallpox
patients can be very sick as soon as a week after infection with the virus but
and this is vital they don't spread the virus until after they're sick
in bed and the spots on the skin start to develop...If smallpox does break out,
vaccination within four days after exposure can prevent or significantly reduce
the severity of illness.
It takes fairly close proximity, within
about six feet of a person suffering the characteristic rash, to breathe in the
smallpox virus and catch the disease. Quickly
vaccinating those who live with or work around a patient is protective.
Another
argument against mass inoculation is that the smallpox vaccine can be
administered after the disease has been contracted, provided it is detected
quickly, WHO head of communicable diseases David Heymann said.
The
incubation period for smallpox is seven to 14 days and the vaccine is effective
if given within four days of infection.
If an intentional release of smallpox (variola)
virus does occur, vaccinia vaccine will be recommended for certain groups.
Groups for whom vaccination would be indicated include
persons
who were exposed to the initial release of the virus;
persons
who had face-to-face, household, or close-proximity contact (<6.5 feet or
2 meters) (84)
with a confirmed or suspected smallpox patient at any time from the onset of
the patient's fever until all scabs have separated;
personnel
involved in the direct medical or public health evaluation, care, or
transportation of confirmed or suspected smallpox patients;
laboratory
personnel involved in the collection or processing of clinical specimens
from confirmed or suspected smallpox patients; and
other
persons who have an increased likelihood of contact with infectious
materials from a smallpox patient (e.g., personnel responsible for medical
waste disposal, linen disposal or disinfection, and room disinfection in a
facility where smallpox patients are present).
Using recently vaccinated personnel (i.e., <3
years) for patient care activities would be the best practice. However, because
recommendations for routine smallpox vaccination in the United States were
rescinded in 1971 and smallpox vaccination is currently recommended only for
specific groups (see Routine Nonemergency Vaccine Use), having recently
vaccinated personnel available in the early stages of a smallpox emergency would
be unlikely. Smallpox vaccine can
prevent or decrease the severity of clinical disease, even when administered
3--4 days after exposure to the smallpox virus (2,4,85).
Preferably, healthy persons with no contraindications to vaccination, who can be
vaccinated immediately before patient contact or very soon after patient contact
(i.e., <3 days), should be selected for patient care activities or
activities involving potentially infectious materials. Persons who have received
a previous vaccination (i.e., childhood vaccination or vaccination >3 years
before) against smallpox might demonstrate a more accelerated immune response
after revaccination than those receiving a primary vaccination (3). If
possible, these persons should be revaccinated and assigned to patient care
activities in the early stages of a smallpox outbreak until additional personnel
can be successfully vaccinated.
"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?"