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Someone You Are Close to May Get the Smallpox Vaccine: What You Should Know and Do

There are some things you should know and do if someone you have close contact with is thinking about getting the smallpox vaccine. (“Close contact” means anyone living in your household. It also means anyone you have close, physical contact with, like a sex partner or someone you share a bed with. Close contact does not mean friends or co-workers.)

BEFORE Vaccination: What You Should Know

The smallpox vaccine is made from a living virus called “vaccinia.” Vaccinia virus is like smallpox virus, but less harmful. The vaccine does not contain the smallpox virus. It can not give you smallpox. The vaccine can protect people from smallpox. For most people, the smallpox vaccine works and is safe.

But, people with certain health conditions are more likely to have serious reactions to the smallpox vaccine. These people should not be vaccinated and they should not be in close contact with someone who has been vaccinated.

BEFORE Vaccination: What You Should Do

Tell your close contact if you have any of the conditions listed below, or even if you have concerns about any of them.

You should NOT be in close contact with someone who has been vaccinated if you:

  • Ever had or now have atopic dermatitis, often called “eczema” (even if you had the condition as a baby or child and even if the condition is mild)
  • Have many breaks in your skin such as those caused by chickenpox, shingles, bad burns, severe acne, poison oak, poison ivy, herpes, psoriasis, pityriasis rosea, impetigo, or other rashes.
  • Have Darier’s disease, a skin disease that usually begins in childhood
  • Have a weakened immune system for whatever reason (HIV/AIDS, cancer and cancer treatment, lupus or other severe autoimmune diseases, primary immune deficiency disorder, or medicines that affect the immune system like high-dose steroids, some drugs for autoimmune disease, or drugs taken for an organ or bone marrow transplant)
  • Are pregnant or might become pregnant within 4 weeks of your close contact’s vaccination

Because of the risk to you (or your baby if you are pregnant), you should not be in close contact with someone who has gotten smallpox vaccine if any of these apply to you.

AFTER Vaccination: What You Should Know

There are things you should know if your close contact gets the smallpox vaccine (even if both you and your close contact don’t have any health problems).

After vaccination, a bump will form at the place on your close contact’s skin where the vaccine was given (called the “vaccination site”). The bump will turn into a blister. It will fill with pus and start to drain. The blister will dry up and form a scab. After about 2 to 3 weeks, the scab will fall off and leave a small scar.

The vaccinia virus in the vaccine (and on your close contact’s vaccination site) is a live virus. Until their scab falls off, a person who has been vaccinated can spread vaccinia virus to other people. This can cause problems such as rash (mild to severe), fever, and head and body aches in the other person.

Vaccinia is spread by touching the vaccination site before the scab has fallen off, or by touching items like bandages, clothes, sheets, or towels that have touched the site.

In the past, the vaccine virus was spread from vaccinated people to others about 2 to 6 times out of every 100,000 people vaccinated for the first time. This usually happened between people who lived together.

AFTER Vaccination: What You Should Do

Until your close contact’s scab falls off:

  • Do not touch your close contact’s vaccination site or any items that have touched it (such as bandages, clothes, sheets, towels, or washcloths used by the person who got the vaccine).
  • Wash with soap and warm water right away if you accidentally touch the vaccination site or items that were in contact with it. Do not touch your eyes or any part of your body until you have washed your hands.
  • If you share a bed with the vaccinated person, be sure that they wear a gauze bandage held in place with first aid tape. To be extra careful, the person who got the vaccine should wear a shirt or pajamas that cover the bandage. If they do not, you may choose to sleep in another bed.
  • Don’t share towels or clothing. Keep clothes, towels, sheets, or other items used by the vaccinated person separate. He or she should machine wash items that have touched the vaccination site using hot water with detergent and/or bleach.
  • Remind the person who got the vaccine to follow the vaccination site care and hand washing instructions they have been given. The vaccination site often becomes itchy, which may lead to scratching, rubbing, or touching of the site. If their hand has vaccinia virus on it and they touch you, you can be infected.

For more about vaccination, see Smallpox Vaccine.

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