TABLE 2

Contraindications to Smallpox Vaccination in Potential Vaccinees Only*

Previous allergic reaction to smallpox vaccine or any of the vaccine's components, including polymyxin B, streptomycin, tetracycline, neomycin, and phenol. Patients with such reactions should not be vaccinated.

Moderate or severe acute illness. Vaccination should be deferred until the illness has resolved.

Symptomatic or asymptomatic heart disease (previous myocardial infarction, angina, congestive heart failure, cardiomyopathy, stroke or transient ischemic attack, chest pain or shortness of breath on activity, or other heart conditions under the care of a physician) or cardiac risk factors (three or more cardiac risk factors: hypertension, diabetes, hypercholesterolemia, heart disease at 50 years of age in a first-degree relative, or current smoker).

Young or old age. Smallpox vaccination is contraindicated in children younger than 12 months. The ACIP advises against nonemergency use of smallpox vaccine in patients younger than 18 years or those older than 65 years.

Breastfeeding. Smallpox vaccine should not be given to women who are breastfeeding.

Latex allergy. Patients who are allergic to latex should not be vaccinated. Note that the vaccine vial stopper contains rubber.



ACIP = Advisory Committee on Immunization Practices.

*--There are no contraindications to vaccination of patients who have had direct exposure to smallpox.

Information from references 8, 11, and 12.