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Small Pox Vaccinations

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The Smallpox Vaccine Program: Should You Volunteer?

Fact #1: The decision to be vaccinated is strictly VOLUNTARY.

  • As a health care worker, you will likely be among those asked to volunteer.
  • The decision you make will affect you, your patients and your family.
  • The decision whether or not to be vaccinated is yours alone.

Fact #2: Smallpox vaccination carries significant risks.

The vaccine infects you with "live" vaccinia virus, a weaker "pox" type virus, that protects you against smallpox.

  • This vaccine has been described as the "least safe human vaccine."
  • Vaccinia virus is not the smallpox virus and cannot give you smallpox.
  • The vaccine is effective in preventing the disease; You also have a 90% chance of preventing the disease if you are vaccinated within four days after exposure to smallpox.

The vaccine can cause severe reactions, complications, and even death.

  • Because the vaccine contains live vaccinia virus, it can spread to other parts of your body or even infect family members, co-workers and possibly patients.
  • Fifteen (15) out of every 1 million people vaccinated for the first time will face life-threatening complications.
  • Many more will suffer from fever and swollen lymph nodes.
  • One third of those vaccinated become sick enough to miss at least one day of work.
  • Severe side effects usually appear within three weeks.
  • One or two people out of every 1 million people vaccinated will die.

It is believed that reactions to the vaccine are less common for those being revaccinated.

  • People who were vaccinated for smallpox in the 50s, 60s, or early 70s may have fewer reactions when they are revaccinated, but reactions can still be severe.
  • It is not clear whether those who were previously vaccinated still have immunity, as it is believed that booster shots are needed every five to 10 years.

Fact #3: You should not volunteer if you have any risk factors.

Don't volunteer to get vaccinated if you have any of these conditions or live with someone who has any of these conditions:

  • HIV, or do not know if you have HIV;
  • Cancer, leukemia, or any other medical conditions that compromise your immune system;
  • Undergoing treatments that compromise your immune system, e.g., radiation, organ transplant medications, steroids, chemotherapy agents, etc.,
  • Skin disorders such as eczema or dermatitis (current or past), impetigo, severe acne, or herpes;
  • Allergies to certain antibiotics used with the vaccine or allergies to latex products;
  • Pregnant, considering becoming pregnant soon, or breastfeeding;
  • Previous allergic reaction to the smallpox vaccine.

Fact #4: Safeguards should be in place.

Before you volunteer to be vaccinated, the following protections should be in place:

  • A training and education program on paid work time that includes the opportunity to ask questions;
  • Free counseling on paid work time to help you decide whether you should be vaccinated;
  • Medical screening and free and confidential medical testing to ensure you and members of your household have no conditions-such as HIV infection, pregnancy, antibiotic allergies, eczema and other skin disorders-related to adverse vaccine reactions;
  • An understandable informed consent form;
  • Plans for on-site daily monitoring and care of the vaccination site and tracking and reporting of complications;
  • A plan to protect immune-compromised patients from recently vaccinated health care workers;
  • Clear policies concerning coverage of lost work time for vaccination-related illnesses;
  • Compensation for personal, family and patient medical costs caused by vaccine complications;
  • A clear, written policy that health care workers will not suffer discrimination for refusing to participate in any smallpox vaccination program; and
  • An agreement to use safer vaccination needles with integrated safety features as required by the federal Needlestick Prevention and Safety Act of 2000.

CWA is working to protect you.

CWA, along with other concerned Unions, is working at the Federal, state and local levels to correct the flaws in the federal vaccination plan and to make sure you are protected in this process. For additional information, contact the U.S. Centers for Disease Control at

For more information contact the:

CWA Occupational Safety and Health Department
501 Third Street, N.W.
Washington, D.C. 20001-2797
Phone: (202) 434-1160

Adapted with permission from CWA District 1.

View all CWA Health & Safety Fact Sheets