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Generalized Vaccinia Rare After Military Smallpox Vaccine

Sixty-six cases per million suspected, but none confirmed in the laboratory

TUESDAY, July 18 (HealthDay News) -- Generalized vaccinia is an extremely rare complication of smallpox vaccination, and none of the cases suspected in military personnel in recent years have been laboratory confirmed, researchers report in the July issue of the Journal of the American Academy of Dermatology.

Felisa S. Lewis, M.D., of the Walter Reed Army Medical Center in Washington, D.C., and colleagues analyzed 74 suspected cases out of 753,226 smallpox vaccinations reported via the U.S. Centers for Disease Control and Prevention's Vaccine Adverse Event Reporting System and various military channels between December 2002 and December 2004.

The researchers found that 66 per million, or 50 of the 74 suspicious cases, met the case definition for possible generalized vaccinia. Some 81 cases per million were suspected in those who were vaccinated for the first time, versus 32 per million cases in revaccinated personnel. Only 15 of the 74 possible cases were sent for laboratory confirmation, and none were virologically positive via skin biopsy, culture or polymerase chain reaction.

"Generalized vaccinia is still a rarely reported complication of smallpox vaccination," the authors write. "True generalized vaccinia, strictly defined, may be even less common than previously reported."

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