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Unintentional transfer of vaccinia virus associated with smallpox vaccines: ACAM2000(®) compared with Dryvax(®).
Hum Vaccin Immunother. 2013 Jul; 9(7):1489-96.HV

Abstract

BACKGROUND

Routine vaccination against smallpox (variola) ceased in the US in 1976. However, in 2002 limited coverage for military personnel and some healthcare workers was reinstituted. In March 2008, ACAM2000® replaced Dryvax® as the vaccine used in the United States against smallpox. Unintentional transfer of vaccinia virus from a vaccination site by autoinoculation or contact transmission, can have significant public health implications. We summarize unintentional virus transfer AEs associated with ACAM2000® since March 2008 and compare with Dryvax®.

RESULTS

We identified 309 reports for ACAM2000® with skin or ocular involvement, of which 93 were autoinoculation cases and 20 were contact transmission cases. The rate for reported cases of autoinoculation was 20.6 per 100,000 vaccinations and for contact transmission was 4.4 per 100,000 vaccinations. Eighteen contact transmission cases could be attributed to contact during a sporting activity (45%) or intimate contact (45%). Of the 113 unintentional transfer cases, 6 met the case definition for ocular vaccinia. The most common locations for all autoinoculation and contact cases were arm/elbow/shoulder (35/113; 31%) and face (24/113; 21%). Methods We reviewed 753 reports associated with smallpox in the Vaccine Adverse Event Reporting System and CDC Poxvirus consultation log, reported from March 2008 to August 2010. Reports were classified into categories based upon standard case definitions.

CONCLUSION

Overall, unintentional transfer events for ACAM2000® and Dryvax® are similar. We recommend continued efforts to prevent transfer events and continuing education for healthcare providers focused on recognition of vaccinia lesions, proper sample collection, and laboratory testing to confirm diagnosis.

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Authors+Show Affiliations

Tack DM
Poxvirus and Rabies Branch; Centers for Disease Control and Prevention; Atlanta, GA USA; Epidemic Intelligence Service; Centers for Disease Control and Prevention; Atlanta, GA USA.
Karem KL
No affiliation info available
Montgomery JR
No affiliation info available
Collins L
No affiliation info available
Bryant-Genevier MG
No affiliation info available
Tiernan R
No affiliation info available
Cano M
No affiliation info available
Lewis P
No affiliation info available
Engler RJ
No affiliation info available
Damon IK
No affiliation info available
Reynolds MG
No affiliation info available

MeSH

AdolescentAdultChildChild, PreschoolFemaleHealth PersonnelHumansMaleMiddle AgedMilitary PersonnelProduct Surveillance, PostmarketingSmallpoxSmallpox VaccineUnited StatesVaccinationVacciniaVaccinia virusYoung Adult

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

23571177

Citation

Tack, Danielle M., et al. "Unintentional Transfer of Vaccinia Virus Associated With Smallpox Vaccines: ACAM2000(®) Compared With Dryvax(®)." Human Vaccines & Immunotherapeutics, vol. 9, no. 7, 2013, pp. 1489-96.
Tack DM, Karem KL, Montgomery JR, et al. Unintentional transfer of vaccinia virus associated with smallpox vaccines: ACAM2000(®) compared with Dryvax(®). Hum Vaccin Immunother. 2013;9(7):1489-96.
Tack, D. M., Karem, K. L., Montgomery, J. R., Collins, L., Bryant-Genevier, M. G., Tiernan, R., Cano, M., Lewis, P., Engler, R. J., Damon, I. K., & Reynolds, M. G. (2013). Unintentional transfer of vaccinia virus associated with smallpox vaccines: ACAM2000(®) compared with Dryvax(®). Human Vaccines & Immunotherapeutics, 9(7), 1489-96. https://doi.org/10.4161/hv.24319
Tack DM, et al. Unintentional Transfer of Vaccinia Virus Associated With Smallpox Vaccines: ACAM2000(®) Compared With Dryvax(®). Hum Vaccin Immunother. 2013;9(7):1489-96. PubMed PMID: 23571177.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unintentional transfer of vaccinia virus associated with smallpox vaccines: ACAM2000(®) compared with Dryvax(®). AU - Tack,Danielle M, AU - Karem,Kevin L, AU - Montgomery,Jay R, AU - Collins,Limone, AU - Bryant-Genevier,Marthe G, AU - Tiernan,Rosemary, AU - Cano,Maria, AU - Lewis,Paige, AU - Engler,Renata J M, AU - Damon,Inger K, AU - Reynolds,Mary G, Y1 - 2013/04/09/ PY - 2013/4/11/entrez PY - 2013/4/11/pubmed PY - 2014/5/28/medline KW - Orthopoxvirus KW - adverse events KW - autoinoculation KW - contact vaccinia KW - smallpox vaccine KW - vaccinia virus SP - 1489 EP - 96 JF - Human vaccines & immunotherapeutics JO - Hum Vaccin Immunother VL - 9 IS - 7 N2 - BACKGROUND: Routine vaccination against smallpox (variola) ceased in the US in 1976. However, in 2002 limited coverage for military personnel and some healthcare workers was reinstituted. In March 2008, ACAM2000® replaced Dryvax® as the vaccine used in the United States against smallpox. Unintentional transfer of vaccinia virus from a vaccination site by autoinoculation or contact transmission, can have significant public health implications. We summarize unintentional virus transfer AEs associated with ACAM2000® since March 2008 and compare with Dryvax®. RESULTS: We identified 309 reports for ACAM2000® with skin or ocular involvement, of which 93 were autoinoculation cases and 20 were contact transmission cases. The rate for reported cases of autoinoculation was 20.6 per 100,000 vaccinations and for contact transmission was 4.4 per 100,000 vaccinations. Eighteen contact transmission cases could be attributed to contact during a sporting activity (45%) or intimate contact (45%). Of the 113 unintentional transfer cases, 6 met the case definition for ocular vaccinia. The most common locations for all autoinoculation and contact cases were arm/elbow/shoulder (35/113; 31%) and face (24/113; 21%). Methods We reviewed 753 reports associated with smallpox in the Vaccine Adverse Event Reporting System and CDC Poxvirus consultation log, reported from March 2008 to August 2010. Reports were classified into categories based upon standard case definitions. CONCLUSION: Overall, unintentional transfer events for ACAM2000® and Dryvax® are similar. We recommend continued efforts to prevent transfer events and continuing education for healthcare providers focused on recognition of vaccinia lesions, proper sample collection, and laboratory testing to confirm diagnosis. SN - 2164-554X UR - https://www.unboundmedicine.com/medline/citation/23571177/Unintentional_transfer_of_vaccinia_virus_associated_with_smallpox_vaccines:_ACAM2000_®__compared_with_Dryvax_®__ L2 - https://www.tandfonline.com/doi/full/10.4161/hv.24319 DB - PRIME DP - Unbound Medicine ER -