ACIP: vaccine not for pregnant women, herpes patients. (Routine Pregnancy Tests not Recommended).

ATLANTA--Up to 30% of hospital-based individuals targeted for smallpox vaccination could be excluded because of pregnancy, dermatologic conditions such as herpes, or HIV infection, according to guidelines that were laid out by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.

ACIP spent 2 days last month hammering out clinical and logistical guidelines for the administration of smallpox vaccine to approximately 510,000 health care workers at U.S. hospitals.

Taken together with the overall recommendation about who should be vaccinated (see accompanying story), these guidelines are likely to be published in a joint statement from ACIP and the Hospital Infection Control Practices Advisory Committee, ACIP chairman Dr. John F. Modlin said during a press conference following an ACIP meeting.

Among the issues that were tackled in the ACIP guidelines:

* Administrative leave/site care. Health care workers would be able to continue caring for patients following vaccination 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 committee said.

The committee chose this option--to be phased in slowly--over proposals to require administrative leave or reassignment until the scab falls off, so as to minimize disruption of health care delivery and to avoid further exacerbation of existing nursing shortages.