Some people should not get the smallpox vaccine unless under emergency situations:
In a smallpox outbreak, even people with exemptions to vaccination should be vaccinated if exposed to smallpox, unless extremely immunosuppressed.
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.
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:
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 MILVAX-VHCN website at www.smallpox.mil/screeningform
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.
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.