2 To vaccinate correctly, use a bifurcated needle. (NOTE: A
single needle may be used by doubling the punctures.) Dip the needle in the vaccine
and touch the skin leaving a droplet. Hold the needle perpendicular to the site and
move the needle point through the droplet in a motion perpendicular to the skin. Give
primary (first) vaccinations by two or three firm pressures within a 1/8th of an inch area.
Revaccinations five years later consist of 15 firm pressures with a bifurcated needle.
With a dry, sterile gauze or Q-tip applicator, dab the remaining vaccine off the arm. A
properly performed vaccination should not bleed freely. Do not apply a dressing unless
a weeping lesion appears and, even then, apply the dressing only to protect the
clothing. The patient should be so advised.
3 About the third day after vaccination, a papule appears at the
vaccination site. The fifth or sixth day this papule becomes a vesicle (small blister).
Erythema (redness of the skin) and induration (a spot which is abnormally hard) follow
and start to subside about the tenth day, followed by a crust formation which comes off
after about 21 days. The primary reaction may be accompanied by lymphadenopathy
(lymph node enlargement), fever, and malaise (a general feeling of bodily discomfort).
4 The vaccination is examined following six to eight days. Any
reaction that shows a pustule, vesicle, or area of definite redness or induration,
regardless of its form, is a MAJOR REACTION. All other responses are termed
EQUIVOCAL REACTIONS. All personnel exhibiting equivocal reactions should be
immediately vaccinated again using a more vigorous technique and another vaccine
lot/batch. Examination of the second vaccination is not necessary and requires no
further attempts whether a major reaction or an equivocal reaction occurs.
5 Vaccination should not be given to patients with eczematous
skin or atopic dermatitis. Patients should be warned of the possible spread by contact
to persons with these disorders. Patients should also be warned to stay out of
swimming pools because of the danger of contaminating the water in such pools.
Vaccinia virus is an agent used for immunization. This agent can be transferred from
one person to another if the vaccinated person is in close personal contact with other
people. Someone touches the site of vaccination and then touches an area where the
skin is scraped or there is a mucous membrane (the mouth, for example). The vaccine
will form stellite lesions in those areas which are touched. For this reason, troops
should be vaccinated early during military training to minimize contact with unprotected
6 Vaccination should only be carried out on healthy individuals.
No country requires a smallpox vaccination for entry at this time. The World Health
Organization declared the earth to be completely free of smallpox in May 1980.
Revaccinations are done after a five year period. No smallpox vaccinations should be
administered unless vaccinia immune globulin is readily available to treat systemic