Antibody response to cutaneous inoculation with vaccinia virus: Viremia and viruria in vaccinated children

Detection of vaccinia virus DNA, but not infectious virus, in the blood of smallpox vaccine recipients

“…The NYCBOH strain of vaccinia has been cultured from the blood of persons with moderate or severe complications of vaccinia [2,3]. Based on these findings, current recommendations for deferral of blood donors in recipients of smallpox vaccine state that persons without vaccine complications should be deferred from donating blood until after the vaccine scab has spontaneously separated or for 21 days after vaccination, whichever is longer [13].…”

“…positive culture for virus in the blood) between the third and tenth day after vaccination [1]. Studies in the 1960's using the NYCBOH strain of vaccinia indicated that viremia is rare, and can occur in immunocompromised persons or in those with multiple cutaneous lesions, but not in those with only localized lesions [2,3]. Cummings et al studied vaccinees receiving the NYCBOH strain vaccinia (Dryvax) and in 2004 they reported no evidence of virus in the blood of serial samples from 28 volunteers (total of 220 specimens) by polymerase chain reaction (PCR), culture, or antigen detection [4].…”

Analysis of cases reported as generalized vaccinia during the US military smallpox vaccination program, December 2002 to December 2004

“…2,3,[7][8][9] European authors during the first part of the 20th century have been cited as finding vaccinia in the blood in the first week after routine vaccination with virus strains other than New York City Board of Health. 23,24 The recent medical literature includes 4 articles that report GV after smallpox vaccination. We believe that these cases warrant further scrutiny.…”

Transmission of Vaccinia Virus and Rationale for Measures for Prevention

“…The New York City Board of Health (NYCBOH) strain is the only one currently used in vaccines licensed in the United States, and it is generally regarded to be the least reactogenic of the strains in use during the era of smallpox eradication [10]. Limited data from the 1950s and 1960s suggest that viremia, viruria, and pharyngeal shedding in association with use of the NYCBOH strain are uncommon (R. Engler, written communication, 8 April 2003) [11,12], although such reactions have been documented with the "hotter," more reactogenic strains often used in Europe and Asia [13]. Viremia and viruria do occur in patients with progressive vaccinia and eczema vaccinatum, which are serious and life-threatening complications of vaccination that occur in individuals with immunodeficiencies and atopic dermatitis, respectively [14] (V.A.F., personal observations).…”

“…However, occlusive dressings may predispose to maceration and possible bacterial superinfection, and therefore we recommend that dressings be changed when the vaccination site is examined or when fluid accumulation is noticed. Daily changes may be required during the period of maximum inflammation and shedding of vaccinia virus (days [4][5][6][7][8][9][10][11][12][13][14].…”