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Contraindications detailed in smallpox immunization plan. (Atopic Dermatitis, Pregnancy, HIV).
ATLANTA -- Up to 30% of hospital-based individuals targeted for smallpox vaccination could be excluded because of dermatologic conditions, pregnancy or HIV infection, according to guidelines laid out by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.
ACIP's guidelines would cover the administration of smallpox vaccine to about 510,000 health care workers at U.S. hospitals. (See story, p. 1). The guidelines are likely to be published in a joint statement by ACIP and the Hospital Infection Control Practices Advisory Committee.
Among the issues tackled in the draft guidelines:
* Administrative leave/site care. Vaccinated workers could continue caring for patients unless they develop severe systemic signs or reactions to the vaccine. They would be required to keep the vaccination site covered with a single semi-permeable dressing (such as Opsite or Tegaderm) over gauze. Dressings must be changed every 3-5 days or when purulent.
The goal is to minimize disruption of health care and avoid further exacerbation of nursing shortages. Data suggest that vaccinia transmission in health care settings was rare during the smallpox vaccine era (JAMA 288[15]:1901-04, 2002).
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