| Popis: |
This chapter deals with the smallpox vaccine, its benefits, its risks, and the current state of its use. To ensure the future availability of appropriate amounts of smallpox vaccine, the U.S. government has funded the manufacture of tissue culture vaccine; the most likely candidate is an Acambis/Baxter Laboratories’ product, grown in Vero monkey kidney cell culture. It is critical to emphasize that the vast majority of vaccinees (nearly all) undergo vaccination without serious complications. The potential vulnerabilities to adverse events after smallpox vaccination are described. It is known that in the era when smallpox vaccination was routine, many patients with hypogammaglobulinemia but with intact T-cell function underwent smallpox vaccination without incidents, presumably because their T-cell immunity was sufficient to contain the virus and to rid the body of infected skin cells, preventing further spread to other areas of the body. It also known that a few individuals with progressive vaccinia virus infection had a lack of T-cell function but intact antibody capacity to various degrees. These individuals had lesser degrees of progression, often without viremic spread. Due to our lack of knowledge of the degree of susceptibility, if any, of individuals with non-T-cell immunodeficiencies, the recommendation has evolved to exclude such individuals from elective smallpox vaccination. The minimal reactions are split into noninfectious consequences of smallpox vaccination and infectious complications. |
