Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: I share Dr Mermel's concerns about
the risk of cutaneous vaccinia from immunized health care workers. Although
vaccinia was rare in hospitals and other health care settings during the 1960s,
it certainly can occur and may have been more frequent at the time of open
wards and before there was great attention to prevention of nosocomial spread.1 Nonetheless, the rarity of such reports in the
1960s seems to indicate that the nosocomial preventive measures used then
were quite effective.
Neff JM. Risk of Cutaneous Vaccinia From Health Care Workers Who Receive Smallpox Vaccine. JAMA. 2003;289(7):844-845. doi:10.1001/jama.289.7.844