Smallpox vaccine and very young children

The last case of naturally occurring smallpox was seen in 1977. In 1980, the World Health Organization (WHO) declared the disease eradicated and recommended that all countries cease vaccinating people against the disease. However, in response to the possibility of smallpox being used as a biological weapon and its public health consequences, the Centers for Disease Control and Prevention (CDC) has developed recommendations for very young children.

What risks does smallpox pose to very young children?

Smallpox in very young children can be severe and even fatal. Children younger than 4 years may have a greater risk of dying from smallpox than older children.

What risks does the vaccine pose to very young children?

All people who receive smallpox vaccine have some risks from the vaccine. Infants younger than 1 year who are vaccinated may have a greater risk of developing complications from the vaccine, such as brain swelling or a total body rash. Brain swelling, which can lead to permanent brain damage or even death, is rare, occurring in about 42 out of every 1 million infants who are vaccinated.1

The body rash that can develop after vaccination is usually mild and goes away on its own. In rare cases, it can be severe and require medical treatment.

Young children may be more likely than others to touch the vaccination site with their hands and transfer vaccine virus to another part of their body (such as the eyelids, face, mouth, or genitals), causing a similar sore. This may be avoided by covering the site, making sure the child doesn't touch the site, and washing the child's hands if he or she does touch it.

Should my child get the smallpox vaccine?

The vaccine is not recommended for children younger than age 18, unless there has been a smallpox outbreak. In an outbreak, everyone who has been in contact with a person with smallpox or was otherwise exposed to the virus should receive the one-dose vaccine, regardless of age, allergies, pregnancy, or medical conditions.

What should I do if my child is vaccinated and I think he or she is having a bad reaction?

Call a health professional right away. Tell him or her what is happening, the date and time that it started, and when the vaccination was given. Your health professional will advise you what to do next.

[Adapted from the CDC's Smallpox Vaccination Clinic Guide1]

Citations

  1. Centers for Disease Control and Prevention (2002). Annex 3: Guidelines for large-scale smallpox vaccination clinics. Available online: http://www.bt.cdc.gov/agent/smallpox/response-plan/files/annex-3.doc.

Last Updated: January 26, 2009

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