HIV/AIDS Program
Smallpox and HIV
Does the smallpox vaccine contain smallpox?
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No, the smallpox vaccine contains a related live virus, vaccinia, which produces immunity to smallpox. The vaccine itself is associated with potentially serious side effects, including (rarely) death. Persons with certain medical conditions, including HIV infection, should not get smallpox vaccine unless they are directly exposed to smallpox. See the resources and links below for more information about smallpox vaccine.
Is smallpox vaccine recommended for persons with HIV infection?
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Persons with HIV infection are at increased risk for severe reactions from smallpox vaccine. Therefore, smallpox vaccine is not recommended for persons with HIV infection regardless of CD4 count unless they are exposed to a smallpox case or the smallpox virus (i.e. during a bioterrorist attack). Because there is no smallpox occurring at this time, smallpox vaccine should not be administered to persons with HIV infection. If persons with HIV infection were actually exposed to smallpox through a bioterrorist attack, vaccination would be recommended.
Should I be tested for HIV before being vaccinated for smallpox?
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Up to 300,000 people in the U.S. may be infected with the HIV virus and not know it. You can have HIV infection and seem to be completely well. Because persons with HIV infection are at risk for severe complications from smallpox vaccine, Public Health recommends HIV testing before smallpox vaccination for any person who has a risk factor for HIV infection, and persons who are unsure of their HIV status.
What precautions should recently vaccinated persons take to prevent spread of the smallpox vaccine to persons with HIV infection?
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Persons with HIV and other conditions causing immune system suppression can have serious complications if they are infected with vaccinia from a vaccinated person, including death. The smallpox vaccine virus (vaccinia) can be spread from the vaccination site of recently vaccinated persons to other people through close, physical contact. Vaccinia is spread by touching a vaccination site before it has healed or by touching bandages, clothing, or other material contaminated with live virus from the vaccination site.
Persons with HIV should not live in the household, or be in close physical contact, with anyone recently vaccinated for smallpox until the scab has separated naturally from the vaccination site or approximately 21 days after vaccination. Persons who are vaccinated are given specific instructions about caring for their vaccination site to minimize risk of transmission of the vaccine virus to others.
To learn about precautions related to contact with someone who has received the smallpox vaccine, see the following CDC web page: www.bt.cdc.gov/agent/smallpox/vaccination/close-contacts.asp
For more information about smallpox vaccination see the following web sites:
For more detailed information about HIV and smallpox vaccination in King County, please call the HIV/STD Hotline at 206-205-7837.
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