Questions & Answers
Smallpox - Vaccine Safety
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Vaccination Site Care

  1. Are there precautions I can take as a healthcare provider to help my patients avoid spreading smallpox vaccine virus to others?

    You should follow the same instructions on "How should I care for the vaccination site?" and read the following:

    Even patients vaccinated in the past may be at increased risk due to current immunodeficiency. If contact with unvaccinated patients is essential and unavoidable, healthcare workers can continue to have contact with patients, including those with immune deficiencies, as long as the vaccination site is well-covered and thorough hand-hygiene is maintained. In this setting, a more occlusive dressing might be appropriate. Semi-permeable polyurethane dressings (e.g., Opsite®, Tegaderm®) are effective barriers to vaccinia and recombinant vaccinia viruses.

    However, exudate may accumulate beneath the dressing, and care must be taken to prevent viral contamination when the dressing is removed. In addition, accumulation of fluid beneath the dressing may increase the maceration of the vaccination site. To prevent accumulation of exudates, cover the vaccination site with dry gauze, and then apply the dressing over the gauze. The dressing should also be changed daily or every few days (according to type of bandaging and amount of exudate), such as at the start or end of a duty shift.

    Military treatment facilities will develop plans for site-care stations, to monitor workers' vaccination sites, promote effective bandaging, and encourage scrupulous hand hygiene. Wearing long-sleeve clothing can further reduce the risk for contact transfer. The most critical measure in preventing inadvertent contact spread is thorough hand-hygiene after changing the bandage or after any other contact with the vaccination site.

  2. How should I care for the vaccination site?

    Three Key Points:

    1. Don't touch your vaccination site.

    2. If you touch it by accident, wash your hands right away.

    3. Don't let others touch your vaccination site or materials that touched it.

    Vaccinia virus is present at the vaccination site for 30 days and until the vaccination site is completely healed. This means other people can get infected if they come in contact with virus from your arm.

    Most vaccination sites can be left unbandaged, when not in close contact with other persons. Airing the site will speed healing. Wear sleeves covering the site and/or use an absorbent bandage to make a touch-resistant barrier when around others. Dispose of bandages in sealed or double plastic bags. You may carefully add a little bleach, if desired.

    Keep the site dry. Do not use creams or ointments; they will delay healing. Long-sleeve clothing worn during the day and at night can protect the site from dirt. Launder clothing and linens that touch the site in hot water with soap or bleach.

    Normal bathing can continue. Dry off carefully, so the towel does not rub or spread virus elsewhere. Don't allow others to use that towel until laundered. Don't use public towels, unless laundry workers are aware of special handling precautions. Use a waterproof adhesive bandage if you exercise enough to cause a sweat. Avoid swimming pools and spas until the site is completely healed.

    Take good care of your vaccination site.

  3. Does everybody need one of those big bandages I saw on the clinic workers?
    No. Health care workers will get large bandages so they can stay on the job in a healthcare center without taking time off. Regular Band-Aids are sufficient for covering the vaccination site for most people.

  4. How long should the dressing or bandage or Band-Aid stay in place, before being replaced by a new one?
    The dressing or bandage should be kept in place until a change is needed. A change would be necessary when there is enough drainage from the vaccination site to soak the pad. It can be changed more often, if the person wants. Always wash your hands, before and after changing a bandage.

  5. Who should change the dressing or bandage?
    You can change the dressing or bandage yourself if you carefully dispose of it and wash your hands in soapy water before and afterwards. Some healthcare facilities have bandage-changing stations set up for Healthcare workers.

  6. What should I do if the bandage over my smallpox vaccination site gets wet?
    If the bandage over your smallpox vaccination site gets wet, you need to change it. It is important to keep your vaccination site clean and dry. The first step when changing the dressing is to wash your hands. Then replace the wet bandage with a new clean bandage. Put the old bandage in a plastic bag with a small amount of bleach, and throw the bag away. Then wash your hands again. For more information about taking care of your vaccination site, go to the IHB website and read the Smallpox Tri-fold Brochure.

  7. How long does it take for the smallpox vaccination site to heal?
    It takes on average 30 to 60 days for the smallpox vaccination site to heal. Keep in mind that everyone heals at a different rate, some faster than average and others slower than average.

  8. I want to get a tattoo placed on my smallpox vaccination site. How long should I wait?
    Before getting a tattoo, wait until the smallpox vaccination site has fully healed, the scab has fallen off, and the skin is intact and dry. It may take longer than the average 30 to 60 days after your vaccination before the skin is ready for tattooing. Please contact the IHB if you have additional questions.

  9. What should I do if I bump the smallpox scab and it falls off?
    If the scab falls off, put it in a plastic bag with a small amount of bleach and throw the bag away. Wash your hands thoroughly. Replace the old bandage with a new clean bandage, and then wash your hands again. For more information on proper care of your vaccination site, go to the IHB website for the Smallpox Tri-fold Brochure.

  10. What should I do if my smallpox vaccination site touched the shower wall?
    Keep your smallpox vaccination site covered with a bandage while you shower. If the bandage gets wet, after your shower put it in a plastic bag with a small amount of bleach, discard it, and then wash your hands. Then put on a new bandage. If your vaccination site does touch a surface, such as the shower wall, clean the surface with a household disinfectant. This will help to make sure that no smallpox vaccine virus remains on that surface.

  11. My dog came in contact with my used smallpox dressing. What should I do?
    Wash the part of the dog that came in contact with your used dressing. Then wash your hands well. Keep an eye on your pet, and if any rash or sore develops, contact your veterinarian. Remember to continue good hand washing, keep your vaccination site covered, and dispose of used dressings in a plastic bag with disinfectant. For more information on proper care of your vaccination site, go to the IHB website for the Smallpox Vaccine Pets Brochure.

  12. Is it true that the smallpox vaccine virus can be spread to others?
    Yes, the smallpox vaccine virus can possibly be spread anytime there is direct contact with the uncovered vaccination site or contact with fluid from the site. This spread is called "contact transmission." To prevent contact transmission, follow these three simple steps: wash your hands, keep the vaccination site covered, and properly dispose of vaccination dressings.

  13. I got a smallpox vaccination about a week ago. Now my armpit hurts and there is redness and swelling around the vaccination site. What should I do?
    What you are describing sounds like a typical reaction that occurs after the smallpox vaccination known as a "robust take." A "robust take" occurs when your body has a vigorous response to the vaccine. This response is a normal variation and usually goes away on its own; over-the-counter pain relievers may be useful. If you have questions or concerns you may contact a IHB healthcare provider or send us a photo of the reaction via our Ask VHC secure messaging system.