Smallpox vaccine ?????

Specialties Emergency

Published

I was wondering what everyone thinks about the smallpox vaccine. If and when the vaccine becomes available, it has been reccommended that all ER personell should be vaccinated. After doing some research, I'm not sure that I would want to take that risk. I work in a fairly busy (37,000 pts./yr.) community ED in upstate NY.....don't think we would be at risk,except for the nuclear research lab that is located about 30 miles outside of our city.

What will you do if this becomes a reality????

SuziQ

PS. I'm fairly new to this forum...if this has already been discussed....sorry to bring it up again!!!

RNConnieF

324 Posts

Is this going to be the same vaccine we got as children? (Well SOME of us got it) I havn't heard.

Specializes in Oncology/Haemetology/HIV.

I got vaccinated as a child - five times - have the military vaccination card to prove it (was unable to get a "good bubble up " on my arm several times - it looks like more than one type of vaccine used, by the card. Anyone know the immunological value of that?

Oh, the joy of being a Navy brat - a guinepig for unusual vaccines. And that they would vaccinate us in the 60's without a signed consent.

Trauma Columnist

traumaRUs, MSN, APRN

88 Articles; 21,249 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

I work in central Illinois - what would they want here?? The corn??? Seriously, I too was vaccinated while active duty military and don't know how I feel about this. I do feel though that if we are at risk - we should at least get all the info, so that we can make informed decisions.

maureeno

221 Posts

with the way people travel in this country, exposure would be widespread before the first cases even were discovered.

Actual contact, direct or indirect, is not necessary. The virus enters through the respiratory route, multiplying for 1-2 weeks in the lymph nodes and lungs. Next follows 2 days of febrile viremia. It is during this phase it circulates and localizes in the skin. One is contagious well befor the 'pox' appears.

I wish we were all already immunized. The greatest tragedy is we could have eliminated this virus off the face of the earth. Humans choose to keep it around as a weapon.

Specializes in Med/Surg.

There is a really good article in Sep 2002 AJN regarding small pox vaccine. You can also get CE credits from reading the article. I learned a lot. Has pictures even!

Gizmed

6 Posts

This vaccine isn't the same one many of us received as kids, or during our years in the service...and therein lies many of the problems...fact is; that there will be adverse effects for a few of those who get vaccinated (know one that doesn't?) which will undoubtably be highly and VISIBLY published everywhere (raise those ratings!!). As was posted before; its contagious prior to onset of signs...so by the time its out there it will be a bit late. The time to make your personal decision is now. :chair:

I was vaccinated as a child and in the military in 82. Its scary but the alternative could be so much worse. I would really have to think before I said don't keep me safe so I can treat others. Isn't that part of the EMS creed one must protect themselves before one can treat others.All meds and vaccines have side effects and some will have bed and even deathly reactions- but are we proactive or reactive in nursing?

fab4fan

1,173 Posts

I fall into one of the categories that exclude you from getting the vaccine (derm. probs.). It does concern me to some degree, because I live in an area that this could be a problem...there's a stockpile of the virus just about 5mi from my home, and we are very close to several metro areas.

I'll just take my chances...I am NOT getting the vaccine unless I have been exposed; makes me wonder if my derm. probs. that started in childhood were r/t the vaccine.

Kim Steinmann

10 Posts

It appears there is quite a controversy about the smallpox vaccine and there isn't any real guarantees that those who were immunized as children won't have a reaction. There is also a concern that if you were to become disabled as a result, would the hospital pay disability. Our hospital is still researching this.

sunnygirl272

839 Posts

Originally posted by Gizmed

This vaccine isn't the same one many of us received as kids, or during our years in the service...and therein lies many of the problems...fact is; that there will be adverse effects for a few of those who get vaccinated (know one that doesn't?) which will undoubtably be highly and VISIBLY published everywhere (raise those ratings!!). As was posted before; its contagious prior to onset of signs...so by the time its out there it will be a bit late. The time to make your personal decision is now. :chair:

i beg to differ...i was told at work that the current vaccine is the same one that most of you (i missed out, only 30 here) got as a child..there is a new one in the works, with the antibiotics additives, that will be trialed this yr and approved for use by next yr...it is not contagious prior to symptoms...is is considered contagious from when fever or the first lesion appears, to when the last scab falls off...

sunnygirl272

839 Posts

Smallpox Disease

Incubation Period

(Duration: 7 to 17 days)

Not contagious

Exposure to the virus is followed by an incubation period during which people do not have any symptoms and may feel fine. This incubation period averages about 12 to 14 days but can range from 7 to 17 days. During this time, people are not contagious.

Initial Symptoms (Prodrome)

(Duration: 2 to 4 days)

Sometimes contagious*

The first symptoms of smallpox include fever, malaise, head and body aches, and sometimes vomiting. The fever is usually high, in the range of 101 to 104 degrees Fahrenheit. At this time, people are usually too sick to carry on their normal activities. This is called the prodrome phase and may last for 2 to 4 days.

Early Rash

(Duration: about 4 days)

Most contagious

Rash distribution:

View enlarged image.

A rash emerges first as small red spots on the tongue and in the mouth.

These spots develop into sores that break open and spread large amounts of the virus into the mouth and throat. At this time, the person becomes most contagious.

Around the time the sores in the mouth break down, a rash appears on the skin, starting on the face and spreading to the arms and legs and then to the hands and feet. Usually the rash spreads to all parts of the body within 24 hours. As the rash appears, the fever usually falls and the person may start to feel better.

By the third day of the rash, the rash becomes raised bumps.

By the fourth day, the bumps fill with a thick, opaque fluid and often have a depression in the center that looks like a bellybutton. (This is a major distinguishing characteristic of smallpox.)

Fever often will rise again at this time and remain high until scabs form over the bumps.

Pustular Rash

(Duration: about 5 days)

Contagious

The bumps become pustules--sharply raised, usually round and firm to the touch as if there's a small round object under the skin. People often say the bumps feel like BB pellets embedded in the skin.

Pustules and Scabs

(Duration: about 5 days)

Contagious

The pustules begin to form a crust and then scab.

By the end of the second week after the rash appears, most of the sores have scabbed over.

Resolving Scabs

(Duration: about 6 days)

Contagious The scabs begin to fall off, leaving marks on the skin that eventually become pitted scars. Most scabs will have fallen off three weeks after the rash appears.

The person is contagious to others until all of the scabs have fallen off.

Scabs resolved

Not contagious

Scabs have fallen off. Person is no longer contagious.

* Smallpox may be contagious during the prodrome phase, but is most infectious during the first 7 to 10 days following rash onset.

http://www.bt.cdc.gov/agent/smallpox/overview/disease-facts.asp

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