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October 22/29, 2003

Safety of the Smallpox Vaccine Among Military Recipients

Author Affiliations

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

JAMA. 2003;290(16):2123-2124. doi:10.1001/jama.290.16.2123-a

To the Editor: Dr Halsell and colleagues1 reported that myopericarditis occurred at a rate of 1 per 12 819 primary vaccinees in the US military. Similarly, Drs Grabenstein and Winkenwerder2 found that between 0.5% and 3.0% of military vaccine recipients needed short-term sick leave. Both groups of authors concluded that adverse events occurred at rates below historical rates, and that a mass vaccination program could be carried out safely. In both reports, however, vaccine complications were derived using passive rather than active surveillance. Therefore, the very favorable comparison of military adverse effect rates to historical rates is misleading.