To the Editor: Dr Garde and and colleagues1 stated that "The mechanism of transfer from the
vaccinee to the spouse is uncertain." They did not report, however, whether
they asked about mouth-to-nipple contact from the vaccinee to the spouse.
Oral shedding of virus could transmit the virus via direct mucosal contact.
Weed HG. Risk of Contact Vaccinia From Immunization Sites. JAMA. 2004;291(19):2313–2314. doi:10.1001/jama.291.19.2314-a