title: Generalized vaccinia, progressive vaccinia, and eczema vaccinatum are rare following smallpox (vaccinia) vaccination: United States surveillance, 2003.
abstract: Generalized vaccinia (GV), progressive vaccinia (PV), and eczema vaccinatum (EV) are adverse reactions following smallpox vaccination. We investigated all reports suggestive of GV, PV, or EV among United States civilian smallpox vaccinees during 2003 and applied standard case definitions. We identified 29 reports of possible GV among 38,440 vaccinees; 2 (7%) of the reports met the case definition. One case of GV was confirmed by identifying vaccinia from a lesion distant from the vaccine site using polymerase chain reaction. The other case was classified as probable GV, because confirmatory testing was not done. We identified 3 potential EV cases and 7 potential PV cases, none of which met the standard case definition. GV, PV, and EV were rare or absent following smallpox vaccination after careful screening of potential vaccinees. GV may be difficult to distinguish from other rashes, and confirmatory testing is recommended. Careful prevaccination screening probably contributed to the low incidence of these adverse reactions following smallpox vaccination.
authors.affiliation: Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. bno1@cdc.gov
authors.forename: Claudia
authors.initials: C
authors.lastname: Vellozzi
authors.forename: J Michael
authors.initials: JM
authors.lastname: Lane
authors.forename: Francisco
authors.initials: F
authors.lastname: Averhoff
authors.forename: Toby
authors.initials: T
authors.lastname: Maurer
authors.forename: Scott
authors.initials: S
authors.lastname: Norton
authors.forename: Inger
authors.initials: I
authors.lastname: Damon
authors.forename: Christine
authors.initials: C
authors.lastname: Casey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012900:Smallpox Vaccine / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology; D014615:Vaccinia / Q000453:epidemiology* / Q000209:etiology*
chemical_list: D012900:Smallpox Vaccine