title: Estimated prevalence of smallpox vaccine contraindications in Israeli adolescents.
abstract: Routine smallpox vaccination for military recruits was discontinued in Israel in 1996. However, Israeli guidelines recommend post-event mass-vaccination. This study aimed to estimate the rate of Israeli adolescents at risk of severe adverse events after vaccination during 1998-2013.
  
  
  
  The study population included adolescents screened before military service in 1998-2013. Medical parameters correlating with contraindications to smallpox vaccination were retrieved from army databases, and were categorized by severity according to the Israeli post-event strategy.
  
  
  
  Of 1,180,964 individuals, 1.86% had vaccination contraindications in a post-event scenario. An additional 1.24% had contraindications in a pre-event scenario. There was an increase in the percentage of contraindications over time, attributed to the rising incidence of atopic-dermatitis.
  
  
  
  Only a small percentage of the adolescent population is ineligible to receive the smallpox vaccine currently in use. This group may be protected by herd-immunity, or by new-generation vaccines designed to prevent severe adverse events.
authors.affiliation: Department of Pediatrics C, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Israel Defense Forces Medical Corps, Tel Hashomer, Israel. Electronic address: fogelitay@gmail.com.
authors.forename: Itay
authors.initials: I
authors.lastname: Fogel
authors.affiliation: Israel Defense Forces Medical Corps, Tel Hashomer, Israel.
authors.forename: Tal
authors.initials: T
authors.lastname: Brosh-Nissimov
authors.affiliation: Department of Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem, Israel.
authors.forename: Granit
authors.initials: G
authors.lastname: Vager
authors.affiliation: Israel Defense Forces Medical Corps, Tel Hashomer, Israel.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Aviv
authors.affiliation: Israel Defense Forces Medical Corps, Tel Hashomer, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Kassirer
mesh_terms: D000293:Adolescent; D000075202:Contraindications; D003876:Dermatitis, Atopic / Q000453:epidemiology; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008889:Military Personnel; D012189:Retrospective Studies; D012871:Skin Diseases / Q000453:epidemiology; D012899:Smallpox / Q000517:prevention & control; D012900:Smallpox Vaccine / Q000009:adverse effects; D014611:Vaccination / Q000009:adverse effects
chemical_list: D012900:Smallpox Vaccine
keywords: Bioterrorism; Lister; Modified vaccinia Ankara; Smallpox vaccine; Susceptible population; Vaccinia