The risk of smallpox vaccination could outweigh the benefits for patients with AIDS, atopic dermatitis, or immunosuppression, according to a review in the September issue of the Journal of Allergy and Clinical Immunology. Eczema vaccinatum is a potentially lethal complication of smallpox vaccine which can affect those with atopic dermatitis or similar conditions.
“The current CDC guidelines in the setting of a smallpox outbreak include a recommendation to immunize anyone with contact regardless of risk factor for an adverse event,” lead author Renata J.M. Engler, MD, FAAAAI, from the Walter Reed Army Medical Center in Washington, DC, says in a news release.
“Many expert groups are reviewing these questions and considering the fine points of risk-benefit and what other options exist to protect those patients who are at very high risk for serious or even life-threatening smallpox vaccine complications.” Groups especially vulnerable to adverse effects from vaccinia include patients with congenital or acquired immune deficiency diseases such as AIDS, those receiving immunosuppressive therapy for organ transplantation or other conditions, those with active or quiescent atopic dermatitis, and potentially those with similar skin conditions affecting the epidermis.
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