Smallpox Vaccines

By: Danielle Banks
By: Danielle Banks

Currently RMH is waiting on the Virginia Department of Health to release it's plan. Dr. Dale Carroll is the Senior Vice-President of Medical Affairs and Performance Improvement at RMH. He says, "At the current time we're building our plan estimating 150 doses to be administered within the next 60 days."

However, none of those doses will be for patients yet. The first stage of the tentative smallpox vaccination plan is to immunize healthcare providers. Dr. Carroll says, "The purpose is to give them coverage so that if they do pick up a patient that has early smallpox, they are prepared."

The second stage looks at offering the shot to rescue workers, firefighters, and police. Half a million military personnel are also expected to get the vaccine. The public comes next, but not until the new version of the vaccine is ready. Dr. Carroll says, "The new vaccine is still a couple of years off which in my opinion is going to be much better than the old one, but it's still a couple of years off."

2004 is the new vaccine's expected completion date. The scarceness of the current vaccine is the main reason the public is being put on hold. That may seem like a long time, but health officials want you to rest assured that you will have access to the vaccine.

Dr. Douglas Larsen is the Health Director at the Central Shenandoah Health District. He says, "I'm encouraged, but we have a long way to go before we're done with all the training we need to do, but a lot has already been done and we're going to do all we can that is humanly possible to protect the citizens of this area."

Dr. Carroll also says so far there has been a pretty good interest from hospital employees who have been informed about the vaccine. Anyone who doesn't wish to receive it doesn't have to. Extended Web Coverage


  • The name smallpox is derived from the Latin word "spotted" and refers to the raised bumps that appear on the body of an infected person.

Forms of Smallpox

  • Two forms of smallpox, variola major and variola minor.

  • Variola Major: The sever and most common form of small pox, with a more extensive rash and higher fever. Four types of variola major smallpox:
    • Ordinary: The most frequent type, accounting for 90 percent of the cases.
    • Modified: Mild and occurring in previously vaccinated persons.
    • Flat: Very fatal. Very hard to recover from this form of smallpox.
    • Hemorrhagic: Very rare and most serious. Extremely fatal form of smallpox.

  • Variola Minor: A less common presentation of smallpox, and a much less sever disease, with death rates historically of one percent or less.

Where Smallpox Originates From

  • Smallpox is caused by the variola virus that emerged in human population thousands of years ago.

  • Except for laboratory stockpiles, the variola virus has been eliminated.


  • Direct and prolonged face-to-face contact is required to spread smallpox.

  • Can be spread through direct contact with infected bodily fluids or contaminated objects such as bedding or clothing.

  • Rarely, smallpox has been spread by virus carried in the air in enclosed settings such as buildings, buses and trains.

  • Humans are the only natural hosts of variola. Smallpox is not known to be transmitted by insects or animals.

Stages of Smallpox Disease

  • Incubation Period (7-17 days, not contagious) -- Exposure to the virus is followed by an incubation period, which people do not have any symptoms and may feel fine.

  • Initial Symptoms (2-4 days, sometimes contagious) -- The first symptoms of smallpox include fever, malaise, head and body aches, and sometimes vomiting. The fever is usually high, in the range of 101° F - 104° F.

  • Early Rash (4 days, most contagious) -- A rash emerges first as small red spots on the tongue and in the mouth. Usually the rash spreads to all parts of the body within 24 hours. As the rash appears, the fever usually falls and the person may start feeling better. However, by the fourth day, the bumps fill with a thick fluid, the fever will raise again and will last until scabs begin to form on the bumps.

  • Pustular Rash (5 days, contagious) -- The bumps become pustules, sharply raised, usually round and firm to the touch as if there is a small round object under the skin.

  • Pustules and Scabs (5 days, contagious) -- The pustules begin to form a crust and then scab. By the end of the second week after the rash appears, most of the sores have scabbed over.

  • Resolving Scabs (6 days, contagious) -- The scabs begin to fall off, leaving marks on the skin that eventually become pitted scars. Most scabs will have fallen off three weeks after the rash appears.

  • Scabs Resolved (not contagious) -- Scabs have fallen off. Person is no longer contagious.

Source: (Public Health Emergency Preparedness and Response's Web site) contributed to this report.

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