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Video Transcript: Smallpox Vaccine Administration

Segment 7 of 8:
Care of the Smallpox Vaccination Site

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Watch this segment of the video RealOne Player RealOne Player format (4 min 52 sec)

Successful smallpox vaccination produces a lesion on the skin. Vaccinia virus can be cultured from this lesion until the scab separates from the skin, as long as 21 days after vaccination. During this time, care must be taken to prevent spread of the virus to another area of the body or to another person. Proper care of the site will also reduce the chance of secondary bacterial infection.

Healthcare workers must take special precautions to prevent transmission of vaccinia virus in the workplace. We will discuss vaccination site care recommendations for healthcare workers in a moment.

Following vaccination, the site should be loosely covered with a porous bandage such as gauze. The vaccinated person can wear a long sleeved shirt in addition to the dressing to help cover the site.

Vaccinees should be instructed that thorough hand washing with soap and water or disinfecting agents should be performed after ANY direct contact with the site or CONTACT with materials that have come into contact with the site.

Care must be taken to prevent contact of the site or contact with contaminated materials from the site by any other person. Keeping the site covered provides barrier protection against inadvertent inoculation or transmission.

Recently vaccinated healthcare workers should utilize additional vaccine site precautions while at work. They should cover the site with an absorbent material such as gauze that is in turn covered by a semipermeable dressing. This provides an additional barrier to prevent contact transmission during patient care activities.

As the vaccination site heals it will itch. The vaccine recipient must make a conscious effort not to scratch the lesion. The vaccine recipient should consider wearing a sleeved shirt to bed in addition to the dressing to avoid scratching the lesion or contaminating the bedding while sleeping.

An occlusive bandage should not be routinely used because maceration of the site might occur. Bandages used to cover the vaccination site should be changed every day to prevent maceration of the vaccination site caused by fluid buildup. Contaminated bandages should be disposed of in a manner that would prevent others from coming into direct contact with them. This may be done by placing the dressings in a sealed plastic bag before disposal in the trash. The site scab should also be appropriately disposed of after it has fallen off.

The vaccination site should be kept dry, although normal bathing can continue. A waterproof bandage can be used while bathing but should be changed back to a porous bandage such as gauze after bathing.

No salves or ointments should be placed on the vaccination site. Clothing or other cloth materials, such as bedding, that have had contact with the site can be cleaned with routine laundering in hot water. Individuals should wash their hands after handling any contaminated clothing or bedding.

Remember, the most critical measure in preventing inadvertent implantation and contact transmission following smallpox vaccination is thorough hand washing after changing the bandage or after any other contact with the vaccination site. The importance of hand washing must be stressed to every vaccinated person.

Additional information about smallpox vaccine, vaccination site care, recognition and treatment of adverse events, and medical screening guidance, including updated recommendations from the Advisory Committee for Immunization Practices is available on our websites. The address of the CDC National Immunization Program website is The address of the CDC Public Health Emergency Preparedness and Response smallpox website is

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  • Page last updated December 13, 2002
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