ACAM2000, a live vaccinia virus vaccine, is the only smallpox vaccine currently licensed and available in the United States (U.S.) for vaccination of persons at risk for orthopoxviral disease. ACAM2000 is produced in Vero cells and derived from a clonal isolate of Dryvax, the New York City Board of Health strain widely used during the smallpox eradication campaign [1-5]. Like Dryvax, ACAM2000 is administered percutaneously using a bifurcated needle, and comes with potential risks of serious adverse events [6-7]. Recommendations of the U.S. Advisory Committee on Immunization Practices (ACIP) regarding smallpox (vaccinia) vaccination, most recently revised in 2003, specify Dryvax as the designated smallpox vaccine in routine non-emergency vaccination programs, which primarily involve laboratory and health-care personnel, as well as select military personnel [8-9]. However, as the license for Dryvax was withdrawn in 2008, and remaining vaccine supplies were subsequently destroyed, the need to develop new ACIP recommendations based on ACAM2000 is paramount [10]. Thus, the ACIP Smallpox Vaccine Work Group has applied the GRADE framework to the available evidence evaluating the administration of ACAM2000 in laboratory and health-care personnel at risk for orthopoxviral disease due to occupational exposure.

  • Background paper
  • Americas
  • United States of America
  • Smallpox