Preventing Contact Transmission

Unlike other current immunizations, smallpox vaccination is characterized by a virus that propagates in the skin and can potentially contaminate the vaccinee’s hands or the skin and mucosa of others with whom the vaccinee comes into contact.

It is important to prevent dissemination of the vaccinia virus from the vaccination site to other parts of the vaccinee’s body or to others.

General principles for the care of vaccinees and the protection of healthcare system employees and susceptible patients follow.

Vaccines
Advise vaccinees and/or guardians that until the scab has separated from the vaccination site:

• Keep the vaccination site covered (1)
• Do not touch, scratch or rub the vaccination site (2)
• Avoid person-to-person contact with susceptible persons
• Avoid touching, rubbing or otherwise performing any maneuvers that might transfer vaccinia virus to the eye or surrounding skin
• Carefully discard the vaccination site covering (3)
• After handling the vaccination site covering, thoroughly wash hands with soap and running water.
(1) Sterile gauze (loosely taped) is recommended.
(2) A special problem because the site is usually itchy.
(3) The covering contains viable virus and can spread the infection to others. Carefully enclose the gauze in a plastic bag that can be sealed prior to placing it in a trash receptacle.

HealthCare Systems
Contact with vaccinees can pose a threat to:
ï Unimmunized health care workers
ï Susceptible patients

This is especially true for entry points into the health care system, such as Emergency Rooms.

Isolate Patient

If a patient presents with a recent vaccination, it is critical for him/her to avoid contact with either unimmunized healthcare workers or patients with known immunosuppression or other susceptibility to contact infection. Although the risk may be slight from casual contact, there is the possibility of inadvertent transfer from person to person or from infected materials used in a vaccinee’s care.

Treat Contaminated Materials as Infectious Waste

In addition to patient isolation, great care must be taken to keep all materials that might be contaminated separate from general areas:
ï Towels
ï Gowns
ï Instruments
ï Etc.

These materials should be placed in an appropriate container and treated as infectious waste.