Some conditions respond to intravenous vaccinia immunoglobulin (IV-VIG), including eczema vaccinatum, progressive vaccinia, severe ocular vaccinia, severe generalized vaccinia. IV-VIG is not effective in treating post-vaccinial encephalitis.
IV-VIG consists of human IgG antibody from people vaccinated with smallpox vaccine. Current supplies of IV-VIG are limited.
Once a definite or probable diagnosis of a medication-indicating adverse event has been made by a qualified provider (e.g., infectious-disease, dermatology, allergy-immunology physician), that military provider may request use of IV-VIG for a named patient by telephoning the Immunization Healthcare Branch at 877-GET-VACC, DSN 761-4245, email DoDVaccines@mail.mil. Procedures for ordering IV-VIG appear at www.smallpox.mil/documents/1101MIP-VIG-ordering-infoNo07.pdf. Healthcare providers from civilian institutions should contact the CDC directly by calling the CDC Director's Emergency Operation Center (DEOC) at (770) 488-7100 and request to speak with the Division of Bioterrorism Preparedness and Response (DBPR) on-call person. The CDC is the release authority for IV-VIG.
The Food and Drug Administration has not approved the use of any antiviral compound for the treatment of the smallpox vaccine virus infections or other Orthopoxvirus infections, including smallpox (variola infection). Certain antiviral compounds are effective against smallpox vaccine virus (vaccinia) or other Orthopoxviruses in vitro and among test animals. However, the safety and effectiveness of these compounds for treating the vaccinia vaccination complications or other Orthopoxvirus infections among humans is unknown. Questions also remain regarding the dosing, timing and length of administration of these antiviral compounds.
Additional information could become available. Health-care providers should consult infectious disease experts for updated information regarding treatment options for the smallpox vaccination complications.