PEDIATRICS Vol. 39 No. 6 June 1967, pp. 916-923
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COMPLICATIONS OF SMALLPOX VACCINATION UNITED STATES 1963

II. Results Obtained by Four Statewide Surveys

John M. Neff M.D.1, Ronald H. Levine M.D.1, J. Michael Lane M.D.1, Ernest A. Ager M.D.1, Helen Moore M.D.1, Beryl J. Rosenstein M.D.1, J. Donald Millar M.D.1, and Donald A. Henderson M.D.1

1 A Combined study undertaken by the Smallpox Unit of the Communicable Disease Center, Public Health Service, U.S. Department of Health, Education, and Welfare, Atlanta, Georgia, in conjunction with the State Health Departments of North Carolina, Rhode Island, Washington, and Wyoming

Four thousand nine hundred physicians in four states, representing 4.8% of the population of the United States, were surveyed in order to assess the frequency and types of complications that occurred during 1963 in association with smallpox vaccination. Four hundred ninety-one physicians initially reported observing 810 complications during this year. On follow-up of these cases, many were not actually complications or were complications that occurred in a year other than 1963.

Accidental infection was the most common complication. Generalized vaccinia and eczema vaccinatum occurred at a frequency of 238 and 80, respectively, per million primary vaccinations. Severe complications were infrequent. No deaths and only one case each of post-vaccinal encephalitis and vaccinia necrosum were detected. The high frequency of many preventable complications and the disproportionate frequency of complications in infants suggest that morbidity and mortality now associated with smallpox vaccination could be significantly reduced if primary vaccination could be deferred until after the first year of life and if more care were taken to detect individuals in whom complications can be expected to occur.

Submitted on November 14, 1966
Accepted on December 27, 1966




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