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CDC publishes ACIP smallpox vaccine guidelines for persons with occupational exposure
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The CDC’s Advisory Committee on Immunization Practices published guidance recommending laboratory personnel handling vaccinia virus or other infecting orthopoxviruses receive routine live smallpox vaccine.
In addition, health care personnel who currently treat patients with or anticipate exposure to vaccinia virus should consider vaccination, according to the guidelines unanimously recommended during a committee meeting in 2015.
“Vaccinia virus smallpox vaccine has been recommended by ACIP for the protection of laboratory personnel against orthopoxviruses since 1980,” the researchers wrote. “However, 14 orthopoxvirus infections were reported in laboratory personnel in the United States during 2004-2014; 13 of these infections occurred in laboratory personnel who were not vaccinated according to ACIP recommendations.”
These recommendations — which update previous guidance established in 2001 — were developed using the Grading of Recommendations Assessment, Development and Evaluation methodology, which involve identifying and qualifying various data to formulate a final decision. Major evidence considered by the committee included the development of the Acam2000 (Sanofi Pasteur Biologics) vaccine and findings suggesting a lower incidence of serious adverse events than previously believed.
Laboratory personnel who directly handle either cultures or animals with replication-competent vaccinia virus, recombinant vaccinia viruses derived from replication-competent vaccinia strains or other orthopoxviruses affecting humans should receive vaccination, according to ACIP. Personnel working with more virulent orthopoxviruses such as variola or monkeypox are recommended to revaccinate every 3 years, while others should be revaccinated after 10 years. Vaccination is not recommended for those working strictly with replication-deficient poxvirus strains.
Although health care personnel or animal care personnel whose only contact is limited to the handling of contaminated materials or vaccine administration are at reduced risk, these groups also may consider immunization. Outside of emergency situations, persons with increased risk for adverse events should not receive the Acam2000 vaccine.
“ACIP will review these recommendations as new information or developments related to orthopoxvirus disease, smallpox vaccines (including licensure of additional smallpox vaccines), smallpox vaccine adverse events and the experience gained in the implementation of these recommendations becomes available,” they concluded. – by Dave Muoio
Disclosure: The researchers report no relevant financial disclosures.
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