Smallpox can be prevented through the use of the smallpox vaccine. The World Health Organization (WHO) used smallpox vaccine to eradicate natural smallpox from the planet. About 95% of people are protected within 10 days of getting a single smallpox vaccination.
Until recently, most service members had not been vaccinated against smallpox. The rest don't have much immunity left from vaccine given years ago. Until the late 1970s, many billions of people around the globe received smallpox vaccine. Smallpox vaccine is still used routinely to protect a small number of people who work with smallpox vaccine virus (vaccinia) or similar viruses. Between December 2002 and January 2008, more than 1.4 million service members received smallpox vaccination.
There is no proven treatment for the smallpox disease, but research to evaluate new antiviral medications is ongoing. Patients infected with smallpox can benefit from supportive therapy (e.g., intravenous fluids, medicine to control fever or pain) and antibiotics for any secondary bacterial infections that occur from all the skin problems smallpox causes.
Research indicates that the first dose of smallpox vaccine offers an increased level of protection from smallpox for 3 years. Immunity decreases thereafter. Substantial, but waning immunity persists for 7-10 years. Subsequent vaccinations increase and extend protection. After 3 doses substantial protection persists for >30 years.
In that European study, about 30% of unvaccinated people infected with smallpox died. About 1.4% of people vaccinated up to 10 years earlier died. Among people vaccinated 11 to 20 years earlier, 7% died. Among people vaccinated 21 or more years earlier, 11% died. These data show that immunity falls off over time and that revaccination is needed to maintain immunity. [Mack TM. Smallpox in Europe, 1950-1971. J Infect Dis 1972; 125:161-169]
In December 2002, the Secretary of Defense decided to vaccinate certain emergency response and medical personnel and other designated personnel that constitute critical mission capabilities to include those essential to the accomplishment of U.S. Central Command's (CENTCOM) missions. In June 2004, DoD expanded the program to include more forces and people in Korea, the US Pacific Command Forward Deployed Naval Forces and CENTCOM Area of Operations (AOR). In September 2007, the ASD (P & R) changed the pre-deployment timeframe for smallpox vaccine administration to 120 days.
For complete information regarding policy, please review the "Policy" section of our website under "Resource Center".
We begin with the assumption that any service member covered by this policy who refuses vaccination may be uninformed about the facts related to the deadly effects of the smallpox virus and the protection afforded by the vaccine. Our first action with those who might refuse the vaccine will be to determine their concern and provide information.
This is a force protection issue. If a service member continues to refuse the vaccine, then a commander will manage the situation as he or she would for any failure to obey a lawful order, including educating the member about the smallpox vaccine as appropriate.