Smallpox Vaccine Alert: Use only three needle sticks for first-time vaccinees
CDC cites liability issue in shifting gears
Health care workers receiving their first lifetime vaccination for smallpox only should be stuck three times with the bifurcated immunization needle — not the 15 skin pricks previously recommended by the Centers for Disease Control and Prevention (CDC).
In an untimely glitch just as some programs were getting under way, the CDC’s Advisory Committee on Immunization Practices (ACIP) cited liability issues in revising the prior recommendation. ACIP had recommended 15 needle sticks for both "naïve" never-vaccinated people and those who had been previously immunized.
The idea was to enhance the number of "takes" conferring immunity and give out a uniform recommendation for vaccination. However, that recommendation was not in harmony with the original package insert by Wyeth Pharmaceuticals in Madison, NJ.
"Because this is a federally executed program, the use of the vaccine must conform with the package insert," says William Schaffner, MD, a liaison ACIP member and chairman of the department of preventive medicine at Vanderbilt University School of Medicine in Nashville, TN.
"And Wyeth obviously has old data submitted to the Food and Drug Administration that support two to three pokes for naïve people and 15 with people who have been previously vaccinated. The question now is whether we will see fewer takes."
To ensure three needle insertions are sufficient for first-time vaccinees, smallpox vaccinators should look for a trace of blood to appear at the site of vaccination. If no blood is visible within 15 to 20 seconds, an additional three insertions should be made using the same bifurcated needle without reinserting the needle into the vaccine vial, ACIP recommends.
The change means some additional training for screeners and vaccinators because they must be aware of the new information to immunize health care workers. If it not clear whether people being immunized have been vaccinated previously, the current thinking is that they should be treated as revaccinees and given 15 needle insertions, Schaffner says.
Health care workers receiving their first lifetime vaccination for smallpox only should be stuck three times with the bifurcated immunization needle not the 15 skin pricks previously recommended by the Centers for Disease Control and Prevention (CDC).
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