title: Risk of vaccinia transfer to the hands of vaccinated persons after smallpox immunization.
abstract: Transmission of vaccinia virus after smallpox vaccination is a concern. We conducted a prospective examination of the protection afforded by vaccination-site bandages in recently vaccinated individuals. After smallpox vaccination, inoculation sites were covered with 2 occlusive dressings. Site assessment and bandage changes occurred every 3-5 days until the site was healed. At each visit, specimens from the vaccination site, outer dressing surface, and contralateral hand were obtained for vaccinia culture. For 148 vaccinated subjects, vaccinia was detected from vaccination lesions of every subject on several occasions. Only 6 (0.65%) of 918 dressing (95% CI, 0.24%-1.4%) and 2 (0.22%) of 926 hand (95% CI, 0.03%-0.78%) specimens tested positive for vaccinia. The mean number of bandage changes was 9.6 (95% CI, 9.17-10.0). Vaccinia autoinoculation did not occur. The rate of vaccinia recovery outside occlusive bandages covering smallpox vaccination sites was remarkably low, suggesting excellent protection against inadvertent transmission.
authors.affiliation: Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA. tom.talbot@vanderbilt.edu
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Talbot
authors.forename: Ellis
authors.initials: E
authors.lastname: Ziel
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Doersam
authors.forename: Bonnie
authors.initials: B
authors.lastname: LaFleur
authors.forename: Sharon
authors.initials: S
authors.lastname: Tollefson
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Edwards
mesh_terms: D000328:Adult; D005260:Female; D006225:Hand / Q000821:virology*; D006801:Humans; D008297:Male; D009779:Occlusive Dressings; D012307:Risk Factors; D012899:Smallpox / Q000517:prevention & control; D012900:Smallpox Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D014611:Vaccination / Q000009:adverse effects*; D014615:Vaccinia / Q000635:transmission*; D014616:Vaccinia virus
chemical_list: D012900:Smallpox Vaccine