Smallpox Vaccine Adverse EventsPublic Health Guidance for Clinicians

A Teaching Set Reviewing Key Points in the MMWR Report

Expected Vaccination Site Reaction

Normal ReactionDay 7

Normal ReactionDay 12

Major ReactionFirst time vaccinee, Day 6

Major ReactionFirst time vaccinee, Day 10

Major ReactionFirst time vaccinee, Day 15

Major ReactionRevaccinee, Day 4

Major ReactionRevaccinee, Day 8

Major ReactionRevaccinee, Day 10

Major ReactionRevaccinee, Day 15

Fatigue Headache Myalgia Lymphadenopathy Lymphangitis Pruritis Edema at the vaccination site Satellite Lesions

Expected Range of Vaccine Reactions

Rates of Expected Reactions

21% complications required physician consult Most Common Symptoms

Fatigue (50%) Headache (40%) Muscle aches and Chills (20%) Nausea (20%) Fever 37.7 ºC or 100 ºF (10%)

Satellite LesionsNaïve Patient, Day 7

Satellite Lesions

Large Vaccination Reactions and Robust TakesRobust take with lymphangitis

Large Vaccination Reactions and Robust TakesRobust take with lymphangitis

Large Vaccination Reactions and Robust TakesLarge Local Reaction