Routine childhood immunization against smallpox in the United States ceased in 1971, according to background information in the article. Although the World Health Organization declared in 1980 that smallpox had been eradicated worldwide, there is concern that smallpox virus may exist outside the World Health Organization−designated repository laboratories and may be used as a bioweapon. Detection of a smallpox case could represent an intentional bioterrorism event requiring an immediate, coordinated response by public health, medical, and law enforcement personnel to control the outbreak and protect the public.
In January 2003, the U.S. Department of Health and Human Services (DHHS) implemented a voluntary civilian smallpox vaccination program, in which vaccine was administered to federal, state, and local volunteers who might be first responders during a bioterrorism event.
Christine G. Casey, M.D., of the Centers for Disease Control and Prevention, Atlanta, and colleagues examined the vaccine safety profile among civilians who received smallpox vaccine between January 24 and October 31, 2003. The researchers evaluated adverse events reported via the Vaccine Adverse Event Reporting System (VAERS) and the Centers for Disease Control and Prevention.
A total of 37,901 volunteers in 55 jurisdictions received at least 1 dose of smallpox vaccine. VAERS received 822 reports of adverse events following smallpox vaccination (overall reporting rate, 217 per 10,000 vaccinees). A total of 590 adverse events (72 percent) were reported within 14 days of vaccination. Nonserious adverse events (n = 722) included multiple signs and symptoms of mild and
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