Smallpox

Due to concern that terrorists may have access to the smallpox virus and attempt to use it against the American public, the U.S. Department of Health and Human Services (HHS) has been working, in cooperation with state and local governments, to strengthen our preparedness for bioterror attacks, by expanding the national stockpile of smallpox vaccine. The vaccine, which was routinely administered to Americans until 1972, is a highly effective protection against smallpox when given before or shortly after exposure to the virus. Vaccinia is the live virus used in smallpox vaccinations.

It is possible that until the vaccination scab spontaneously separates from the skin, recipients of the vaccinia virus could inadvertently infect close contacts who touch the vaccination site or dressing. The scabs themselves contain infectious virus. In an effort to ensure that the virus is not transmitted through a blood donation, potential donors will be asked by blood collection facilities about history of vaccination or close contact with anyone who has been vaccinated. A vaccine recipient who has had no complications may donate after the vaccination scab has spontaneously separated, or 21 days after vaccination, whichever is the later date. Some individuals who have received a smallpox vaccination may be requested not to donate for an interval of time called a deferral period. Those persons are said to be “deferred.”

Who will be deferred:

• A vaccine recipient whose scab was pulled off or knocked off, and did not spontaneously separate, will be deferred for two months after the date of vaccination.
• A vaccine recipient who has experienced complications will be deferred for 14 days after all vaccine complications are completely gone.
• If a potential donor has had close contact (defined as physical intimacy, touching the vaccination site, touching the bandages or covering of the vaccination site, or handling bedding or clothing that had been in contact with an unbandaged vaccination site) with a vaccine recipient and has developed localized skin lesions without any other symptoms or complications, blood collection facility personnel will visually verify the absence of a scab.
  • If a scab spontaneously separated and is no longer present, there will be no deferral.
  • If a scab was otherwise removed, the donor will be deferred for three months from the date when the contact (that is the vaccine recipient) was vaccinated.
• If the date when the contact received the vaccination is unknown, the potential donor will be deferred for two months from the time of the interview.
• If a potential donor has had contact with a vaccine recipient who has had complications, the donor will be deferred for 14 days from the time that all vaccine complications are gone.
• If a potential donor has had contact with a vaccine recipient who has had no symptoms, the donor will not be deferred and may make a donation.
  

The primary concern with the vaccination scab is to ensure that it is healed, not necessarily how it came off. It is possible to contract smallpox from the vaccination site until the scab is fully healed, which generally occurs when the scab spontaneously separates, or drops off, the skin, usually before 21 days have elapsed. Healing is considered complete when there is no scab, oozing or discharge, bleeding, or opening. Healing is evidenced by pink, uninterrupted skin at the inoculation site.

An individual who wants to receive a smallpox vaccination and who also wishes to donate blood may want to consider scheduling the blood donation before the vaccination.

07/05

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