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May 19, 2004

Risk of Contact Vaccinia From Immunization Sites

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(19):2313-2314. doi:10.1001/jama.291.19.2313-c

To the Editor: In their Brief Report of a tertiary contact vaccinia of a breastfeeding infant, Dr Garde and colleagues1 correctly stated that "there is no [US Centers of Disease Control and Prevention] recommendation against vaccination of other family members when there is a breastfeeding infant in the home." It should be noted, however, that the initial Department of Defense (DoD) Smallpox Vaccination Program (SVP) memorandum from November 26, 2002, stated that "Minimizing close physical contact with infants less than one year of age is prudent until the scab falls off."2 The initial DoD screening for potential vaccine recipients excluded service members living with individuals with several skin diseases and immune suppression but not infants younger than 1 year. The Dryvax package insert recommends against vaccination of nursing mothers and infants younger than 1 year but does not exclude immunization of other family members.3

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