Questions & Answers
Smallpox - Vaccine Safety
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Eligibility Criteria

  1. Are there any medical conditions that would exempt me from taking the smallpox vaccine?

    Some people should not get the smallpox vaccine unless under emergency situations:

    • People whose immune system is not working fully (due to disease, medication, or radiation), such as HIV/AIDS, cancer, transplant, immune deficiency
    • People diagnosed with eczema or atopic dermatitis, now or earlier in life
    • People with current skin conditions, such as burns, impetigo, contact dermatitis, chickenpox, shingles, psoriasis, or uncontrolled acne, until the condition clears up
    • Pregnant women
    • People with a household contact who meets any of the conditions above
    • People with serious heart or vessel conditions (such as angina, heart attack, artery disease, congestive heart failure, stroke, other cardiac problem)
    • People with 3 cardiac risk factors (smoking, high blood pressure, high cholesterol, diabetes, family history of heart disease before age 50)
    • People taking steroid eye drops or ointment
    • Breastfeeding mothers
    • Anyone who had problems after previous doses or is allergic to the vaccine or any component

    In a smallpox outbreak, even people with exemptions to vaccination should be vaccinated if exposed to smallpox, unless extremely immunosuppressed.

  2. Should people with lupus get vaccinated?
    People who have been diagnosed with lupus should talk with their physician about whether or not they should be vaccinated, considering the state of their disease, the medications they take, and their personal risk for specific infections. Several medical studies have shown that people with lupus can be safely and effectively vaccinated against influenza, hepatitis B, pneumococcal disease, and other diseases that would pose a significant risk if they were infected. For military personnel with lupus, providers are authorized to grant medical exemptions according to the patient's specific situation. Medical specialists can advise how to get the best benefit from vaccination in such circumstances.

  3. Can I get smallpox vaccine if I don't have a spleen?

    You should discuss your concerns and your individual situation with your medical provider to be sure.

    Certain medical conditions, such as the absence of a working spleen (asplenia) may increase a person's risk for certain infections. Some vaccines, particularly pneumococcal, meningococcal, and Haemophilus vaccines, are specifically recommended for people without a spleen. People with asplenia are generally not considered immunosuppressed for the purposes of vaccination and should receive routine vaccinations with both live and inactivated vaccines according to the usual schedules.

  4. What other medical conditions should I inform the medical staff about?

    You should inform your Health Care Provider if you have heart disease, with or without symptoms, or if you have three or more known major cardiac risk factors (i.e., hypertension, diabetes, hypercholesterolemia, heart disease at age 50 years in a first-degree relative, and smoking).

    Other contraindications include:

    • Current or a history of skin conditions,
    • Positive for HIV or otherwise immunocompromised or immunosuppressed
    • Pregnant or planning to become pregnant
    • Allergies to vaccine components,
    • Recent or scheduled eye surgery
    • Breastfeeding
    • Contact with children 12 months of age or younger
    • Close contact with any of the above

    Also if you have had a serious reaction to polymyxin B, neomycin, latex or a previous dose of smallpox vaccine it may be a contraindication for you to receive smallpox vaccine at this time. If you have concerns, please consult with your health care provider before vaccination.

    Careful prevaccination screening will help determine any risk issues you may have.

    The standardized DoD smallpox screening form can be viewed at the IHB website at

  5. Will family members be allowed to get the smallpox vaccine?
    Family members and non-essential civilian personnel in designated high-threat areas overseas (e.g., Korea) are authorized to receive smallpox vaccine on a voluntary basis. Our procedures will be consistent with FDA guidelines for use of the vaccine and our need to protect mission critical capabilities of the Department of Defense. It remains the Department's policy to evacuate non-emergency essential civilians and family members from threat areas in crisis situations.

  6. Is it okay to go to my dentist after I receive the smallpox vaccine?
    Yes, if you are careful. Inform your dentist that you have been recently vaccinated. Be sure to cover your vaccination site with a bandage and/or long-sleeve clothing to provide a barrier to protect your dentist.

  7. How long does the vaccination site remain contagious?
    The vaccinia is present at the vaccination site for up to 30 days after vaccination and until the site is completely healed. Other people can get infected through contact with the vaccinia from your vaccination site

  8. If vaccinia gets on a dressing or bandage, how long will it stay alive and capable of being spread to someone else who touches it?

    Vaccinia virus can survive in the environment for about 24 hours. It might survive longer if it stays moist and in the dark. If the bandage dries out, the virus is still present, but less able to spread.

    No matter the time, it is always best to carefully dispose of used dressings or bandages in sealed or double plastic bags. Always wash your hands after handling dressings or bandages.

  9. What should I do if I'm going to be around at-risk people (e.g. small children, eczema sufferers)?

    In a household, people have much more intimate or close contact than in work sites or other social settings (e.g., church, malls). As usual, the key here is to not move the virus from your vaccination site to another person. So be careful when around others and follow the standard precautions (band-aids, long-sleeves, hand-washing).

    Regarding household members with contraindications:
    You shouldn't be vaccinated if you have household members with contraindications to the smallpox vaccine, unless you can be separated from them until your scab falls off (about 14 to 28 days).

    Regarding children under 1 year of age:
    "Minimizing close physical contact with infants less than one year of age is prudent until the scab falls off. If unable to avoid infant contact, wash hands before handling an infant (e.g., feeding, changing diapers) and ensure that the vaccination site is covered with a porous bandage [e.g., Band-Aid, or gauze] and clothing. It is preferable to have someone else handle the infant." This quote comes from the October 2002 recommendations of the Advisory Committee on Immunization Practices.

  10. Can I give blood after a smallpox vaccination?
    People who receive the smallpox vaccine and have no complications will be deferred from donating blood for 4 weeks. Individuals with vaccine complications will be deferred until 14 days after all vaccine complications have completely resolved. Consult your blood-donor center for details.

  11. Does the vaccine get into my blood stream?
    Usually not. Experts believe it is very uncommon for vaccinia virus to move from your vaccination site into your blood stream.

  12. Could people be exposed to the vaccine virus (vaccinia) if I cut myself?
    Spreading the vaccinia virus by cutting yourself is highly unlikely. But you would want to clean up any blood spills to protect people against other blood borne pathogens.

  13. Can I travel after receiving the smallpox vaccine?
    Traveling is permitted after smallpox vaccination. Remember to use Band-Aids or long-sleeved clothing to prevent your vaccination site from touching other people. Wash your hands at appropriate intervals.

  14. I have recently had surgery, is it safe to get the smallpox vaccine?
    If you have recently had surgery, ask your healthcare provider whether it is safe for you to get the smallpox vaccine. You may need to wait until your surgical wound heals before you get the vaccine. This is to prevent the smallpox vaccine virus from infecting your surgical wound. Eye surgery, for example Lasik surgery, is a special contraindication to receiving smallpox vaccine. Smallpox vaccination must be postponed until after your eye has healed. Please contact the IHB if you have questions or concerns.

  15. Is it safe to get a smallpox vaccination if I have herpes?
    Having a history of herpes (either oral or genital) is not a contraindication to receiving the smallpox vaccine. However, if you are having an active herpes outbreak, do not get a smallpox vaccination until your skin lesions have healed. If you have questions or concerns, you may contact a IHB healthcare provider or send us an email message using our Ask VHC secure messaging system.

  16. I have a condition that requires me to use steroid eye drops. Should I receive the smallpox vaccination?
    You should not be vaccinated while you are using steroid eye drops. Steroid eye drops decrease your resistance to eye infections. It is a serious problem if your eye becomes infected with the smallpox vaccine virus. This exposure can happen when you touch your eye when the vaccine virus is on your finger. If you have had refractive eye surgery and are using steroid eye drops you should not be vaccinated until after the prescribed period. If you are planning to have refractive eye surgery, you must wait at least 30 to 60 days after your smallpox vaccination or until the scab has fallen off your vaccination site, whichever is longer. Please contact the IHB if you have any questions.