International Notes Smallpox Vaccination
Following the global eradication of smallpox, the Thirty-Fourth
World Health Assembly of the World Health Organization (WHO) by
resolution amended the International Health Regulations to remove
smallpox from the diseases subject to the Regulations, effective
January 1, 1982 (1).
According to WHO, the collaboration of national health
administrations in withdrawing the requirement for smallpox
vaccination certificates has been very positive. All the countries
of
the world except Chad, in Africa, have advised WHO that an
International Certificate of Vaccination against Smallpox is no
longer
required from any traveler. However, WHO reports that some local
authorities in Democratic Kampuchea may require proof of
vaccination.
Because of the risk of complications of vaccination to both
vaccinees
and their contacts, physicians should give travelers to any country
in
which a certificate may be required a signed statement that
vaccination is medically contraindicated. Smallpox vaccination
should
not be given for international travel.
Reported by the Quarantine Div, Center for Prevention Svcs, and
International Health Program Office, CDC. Editorial Note
Editorial Note: The change in the International Health Regulations
removes smallpox from the list of internationally quarantinable
diseases and eliminates the legal basis for requirement of smallpox
vaccination of international travelers.
A new revision of the International Certificates of Vaccination
from which the smallpox vaccination certificate has been deleted
will
be available in the next several months.
In the United States, smallpox vaccination of civilians is
recommended only if they are laboratory workers directly in contact
with smallpox or other closely related orthopox viruses (2).
In 1981, the California Board of Medical Quality Assurance
revoked
the medical license of a physician who administered smallpox
vaccine
to a 53-year old man with chronic lymphocytic leukemia in an
attempt
to treat recurrent herpes labialis (3). The patient developed
severe
vaccinia necrosum. The California board stayed the revocation of
the
physician's medical license and placed him on probation for 5
years.
Smallpox vaccine is ineffective in the treatment of any
disease.
References
WHO. Smallpox vaccination certificates. Wkly Epidem Rec
1981;56:305.
ACIP. Smallpox vaccine. MMWR 1980;29:417-20.
California Department of Health Services. Inappropriate
smallpox
vaccination for recurrent herpes simplex--medical license
revoked. California Morbidity 1981, November 20:45.
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