Links to other pages within Patient UK which are related to this topic:
Experience | Patient+ | Guidelines | Weblinks | News | Products | Other
Print options:   Other options:   Bookmark and Share

This is a PatientPlus article. PatientPlus articles are written for doctors and so the language can be technical. However, some people find that they add depth to the articles found in the other sections of this website which are written for non-medical people.

Smallpox Vaccination

Post your experience

See also or record on Smallpox.

Introduction and history

Edward Jenner (1749-1823) published work in 1798 entitled "An enquiry into the causes and effects of the variolae vaccinae". This work was done following earlier observations that dairymaids and cowmen did not catch smallpox although they did catch cowpox. Benjamin Jesty (1737-1816) protected his family in a similar way before Jenner reported the first scientific attempt at immunization from a hut near his home in Berkeley, Gloucestershire. Jenner scratched material from a cowpox pustule into the arm of a young local boy, James Phipps, who subsequently developed a pustule and a fever. He remained healthy when subsequently Jenner inoculated him with smallpox. "Vaccinae" means "of the cow" and "vaccination" means "protection from smallpox". At this time there were 23,000 deaths per year from smallpox in England many more across Europe. The case fatality rate was between 20% and 60%.
In 1853 compulsory smallpox vaccination was introduced and in December 1979 the Global Commission for the certification of Smallpox eradication declared the world free of smallpox. In 1980 this was ratified by the World Health Assembly.1 There is now no indication for routine smallpox vaccination.

Smallpox infection

Smallpox is caused by the variola virus, a DNA virus, humans being the only known reservoir for the disease. It is spread by person to person contact with an incubation period of 10 to 14 days. The overall mortality is about 30%.

Smallpox vaccines

The most widely used virus used for smallpox inoculation is vaccinia (derived from the genus Orthopoxvirus). This is a double stranded DNA virus sharing antigenicity with the variola virus usually prepared from calf lymph. Research is underway using recombinant DNA techniques to find a safer vaccine without replication of the vaccinia virus. Current vaccines give protection for 5 years (partial immunity for 10 years or more) with 95%conversion rate after primary vaccination and some protection if given within a few days of exposure. It is administered by multiple skin puncture using a bifurcated needle containing small quantities of the vaccine. A papule develops after 3-5 days and becomes vesicular and pustular over 8-10 days followed by scab and scar formation.2

Adverse effects of vaccination

Smallpox vaccine is less safe than other vaccines used routinely today. A third of recipients get mild vaccine related symptoms. More serious reactions occur infrequently: death (1/million vaccinations); eczema vaccinatum (39/million vaccinations); progressive vaccinia (1.5/million vaccinations); post vaccinial encephalitis (12/million vaccinations); and generalized vaccinia (241/million vaccinations).2

Risk factors

Risk factors for complications and adverse effects include eczema, any conditions disrupting the epidermis (acne, psoriasis, burns, seborrhoeic dermatitis etc), the immunocompromised, immunosuppressed patients, pregnancy, and children under 1 year.2

Recommendations

There is no indication for smallpox vaccination except for:

  • Workers in laboratories where pox viruses are handled and others whose work involves an identifiable risk of exposure to pox virus.

Concerns have been expressed about smallpox in relation to bio-terrorism and the availability of vaccine when half of the world's population is unvaccinated.3

Further information and advice
  • If wider use of vaccine being considered see "Guidelines for smallpox response and management in the post-eradication era".4
  • For further advice and guidance for laboratory staff see Advisory Committee on Dangerous Pathogens and Advisory Committee on Genetic Modification 1990. HMSO ISBN 011885450.
  • Advice on the need for vaccination and contraindications from the PHLS Virus Reference Division telephone 020 8200 4400.
Vaccine availability

When required vaccine can be obtained from:

  • PHLS on 020 8200 4400

Document references
  1. Riedel S; Edward Jenner and the history of smallpox and vaccination.; Proc (Bayl Univ Med Cent). 2005 Jan;18(1):21-5.
  2. Belongia EA, Naleway AL; Smallpox vaccine: the good, the bad, and the ugly. Clin Med Res. 2003 Apr;1(2):87-92. [abstract]
  3. Arita I; Smallpox vaccine and its stockpile in 2005. Lancet Infect Dis. 2005 Oct;5(10):647-52. [abstract]
  4. DoH Guidelines for smallpox response and management in the post-eradication era (smallpox plan)
AcknowledgementsEMIS is grateful to Dr Richard Draper for writing this article. The final copy has passed scrutiny by the independent Mentor GP reviewing team. ©EMIS 2007.
DocID: 409
Document Version: 1
DocRef: bgp25012
Last Updated: 22 Oct 2007
Review Date: 21 Oct 2008

The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.

Patient UK Hearing Impairment Survey

Patient UK are grateful to the 550 people who took part in this survey.
To see the results click here.
If you'd like to leave your feedback, please go to our interactive forum.

Links to other pages within Patient UK which are related to this topic:
Experience | Patient+ | Guidelines | Weblinks | News | Products | Other
Print options:   Other options:   Bookmark and Share
Want to search some more? Use the Google Search box below to search our site.

Related pages in Patient UK

Your Experience (^ top of page)

 Please add your experience about this condition / medicine
 Notifiable Diseases
 Smallpox

 Guidelines on Smallpox

 Smallpox

Recent related news items

 Smallpox vaccine good for biological attack
 Smallpox 'clue' to cancer spread
 Eradication

All news by related topic

 Smallpox news
 Smallpox Vaccine news

Medical equipment


Visit the Patient UK Medical Equipment shop

Books


Visit the Patient UK shop

Other - Useful resources (^ top of page)

Pictures, diagrams, photos, images, etc.
Evidence based medicine
Online textbooks and journals
UK Guidelines
Online Videos
Medline
Other good health sites

Want to search some more? Use the Google Search box below to search our site.

Advertisements











Disclaimer: Patient UK has no control over the content of any external links above. Inclusion does not imply endorsement by Patient UK.

Want to advertise on this site? Find out how >>

Clicking here will take you to the foot of this page where you'll find a list of Information Leaflets which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Support Groups which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Medicines & Drugs which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of diagrams which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of PatientPlus (detailed reference) articles which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of UK Guidelines which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of other selected websites which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Poems and Stories which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Operations and Procedures which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Online Videos which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find links through to our interactive forum.
Here you can follow a link to view existing patient experiences on this subject, or to add your own
Clicking here will take you to the foot of this page where you'll find links to news stories on this subject in our Online Newspaper
Clicking here will take you to the foot of this page where you'll find links to related products
Clicking here will take you to the foot of this page where you'll find links to other useful sources of information
Click here to open a printer-friendly version of this document, in a new window, together with the print dialogue box
Click here to open this document in PDF format
This will offer you the usual PDF options i.e. document navigation, search, zoom and formatted print
Note: this is the best way to print the document
Click here to listen to the MP3 audio recording of this document
Click here to download the audio recording of this document as a podcast, for listening to at your leisure
Click here to open our Dictionaries and Glossaries page
Click here to see related products in our Online Pharmacy
Note: this will open in a new window
Click here to add this page to a social bookmarking site of your choice
Click here if you want to find out more about social bookmarking. This link will take you to the Wikipedia explanation
Note: this will open in a new window
Clicking here will take you to the foot of this page where you'll find a list of Information Leaflets which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Support Groups which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Medicines & Drugs which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of diagrams which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of PatientPlus (detailed reference) articles which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of UK Guidelines which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of other selected websites which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Poems and Stories which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Operations and Procedures which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find a list of Online Videos which are related to the topic you are currently viewing
Clicking here will take you to the foot of this page where you'll find links through to our interactive forum.
Here you can follow a link to view existing patient experiences on this subject, or to add your own
Clicking here will take you to the foot of this page where you'll find links to news stories on this subject in our Online Newspaper
Clicking here will take you to the foot of this page where you'll find links to related products
Clicking here will take you to the foot of this page where you'll find links to other useful sources of information
Click here to open a printer-friendly version of this document, in a new window, together with the print dialogue box
Click here to open this document in PDF format
This will offer you the usual PDF options i.e. document navigation, search, zoom and formatted print
Note: this is the best way to print the document
Click here to listen to the MP3 audio recording of this document
Click here to download the audio recording of this document as a podcast, for listening to at your leisure
Click here to open our Dictionaries and Glossaries page
Click here to see related products in our Online Pharmacy
Note: this will open in a new window
Click here to add this page to a social bookmarking site of your choice
Click here if you want to find out more about social bookmarking. This link will take you to the Wikipedia explanation
Note: this will open in a new window
Click here to return to the home page
Click here to read our 'About Us' page
Go to the Emis Access website, where you can book an appointment with your GP, order a repeat prescription or view you medical record online.
Note: this will open in a new window
View and/or join in discussion about health, lifestyle and disease in our interactive forum.
Note: this will open in a new window
Visit our pharmacy product price comparison website
Go to our online newspaper for current medical news and commentary.
Note: this will open in a new window
Adverts on this site do not influence the medical content. Click to read more.
Adverts on this site do not influence the medical content. Click to read more.