The vaccine for smallpox can cause Eczema vaccinatum. It can be fatal for people with the skin condition.

The United States stopped routine vaccinations against smallpox in 1972 because of the public health threat of the disease.

The vaccine is only given to people who are in the military, the Department of Defense, and the biological laboratories. It is important to know the symptoms of the condition, because it is very rare. It is best to start treatment immediately for eczema vaccinatum.

This rare condition is explained in more detail.

Eczema vaccinatum (EV) is a complication that sometimes occurs as a result of the smallpox vaccination. This complication only occurs in people who have eczema.

EV causes a painful rash, fever, and other symptoms. It is most dangerous to young children and always requires medical treatment. EV can be fatal in severe cases.

The symptoms of EV are very noticeable. People with EV are very sick very quickly. After receiving a vaccine, there are symptoms that can occur. Symptoms include:

Some forms of the smallpox vaccine contain a live virus. This viral material is normally harmless. Most people who receive the smallpox vaccine have mild symptoms such as a sore arm or a slight fever for a day or two but have no long-term or serious complications. In fact, EV doesn’t occur as a result of the injected live virus. Rather, EV develops when the live virus gets into the body through your skin.

Eczema damages the skin’s natural barriers. People with eczema are at higher risk of bacterial, fungal, and viral skin infections. These infections may be more complex for people with eczema than standard cases and they require additional or specialized treatments. Similarly, people with eczema can develop an infection if the live virus contained in the smallpox vaccine touches their skin. This can happen if a person with eczema:

  • The site of their vaccine is touched before it is fully healed.
  • The bandage was covering their vaccine site.
  • There is an unhealed vaccination site where an item came in contact with.
  • Itches their site.
  • Personal items such as clothing, towels, or washcloths are touched by another person.

Sometimes, people with eczema can spread the smallpox vaccine virus without realizing it. For instance, a person with eczema could remove their bandage believing the site is completely healed. Later, they could apply their standard nightly lotion or corticosteroid cream. If the vaccination site wasn’t fully healed, applying lotion can spread the virus, and can even help it penetrate the skin.

Doctors can usually diagnose EV during a single exam. The skin lesions are very different.

The only people who develop EV are people with eczema who have come in contact with the vaccine. Doctors can rule out or confirm EV quickly with this.

The CDC and FDA recommend vaccinia immune globulin as a treatment for EV, and the FDA has approved it.

The treatment is given over a period of several days. Treatment is most successful when it is started early. Additional treatment might be needed in some cases. Antibiotics are sometimes prescribed to treat infections.

EV is very rare. The risk is greatest if you have eczema and receive the vaccine.

The smallpox vaccine isn’t recommended for people with eczema or for people who share households with people with eczema. This includes people who haven’t had recent eczema flare-ups. For instance, adults who no longer have eczema flare-ups, but who had childhood eczema, are not candidates for the smallpox vaccine.

It’s important to note that some people with other chronic skin diseases, such as Darier’s disease, are also not candidates for the smallpox vaccine.

Talk with a medical professional if you have any chronic skin condition and if you, or anyone in your household, need a smallpox vaccine for any reason. There are alternative smallpox vaccines available for people with immune conditions like eczema and HIV.

The vaccine is only required in a few settings in the US.

  • military people
  • Department of Defense employees.
  • laboratory workers

EV can be fatal in severe cases. EV is the most dangerous for young children. EV can spread to others while skin is open.

It takes 21 days for the blisters to form and then fall off. Eczema can make skin healing take longer.

It is a rare condition. The vaccine causes the skin of people with eczema to become dry.

“The live virus can cause someone to become very ill if it travels through the damaged skin barriers. EV can be fatal if someone doesn’t get treatment right away.”

“The vaccine for smallpox isn’t given as often as it should. The vaccine is only given to certain military, Department of Defense, and laboratory workers. The vaccine for people with immune compromised skin has been developed.”

EV is a very rare condition, but it is serious. If you have a skin condition like eczema, it is important to understand EV and be safe if you ever get the vaccine.