Smallpox Immunization in the 21st Century
The Old and the New
Mary E. Wright, MD MPH;
Anthony S. Fauci, MD
JAMA. 2003;289:3306-3308.
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Just over 6 months ago a decision was made to reinstitute smallpox vaccination for selected segments of the US population.1 This decision to implement a pre-event smallpox vaccination program was based on the concern that smallpox could be used as an agent of bioterrorism; however, certain questions about the risk of smallpox vaccination in a 21st-century setting arose.2-3 Among these was the possibility that the current United States population might be more vulnerable to serious adverse effects of the smallpox vaccine due to a relative increase—compared with 3 to 4 decades ago—in conditions affecting the immune system such as the use of immunosuppressive drugs and the presence of human immunodeficiency virus infection in the community. A consequence of this change in population profile could be an increased incidence of established adverse events as well as the emergence of heretofore unrecognized adverse . . . [Full Text of this Article]
Author Affiliations: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services.
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