WHO Announces Updated Guidance on Smallpox Vaccination
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Statement to the press by the director-general of the world health
Organization, Dr Gro Harlem Brundtland

World Health Organization Announces Updated Guidance On Smallpox Vac-
cination

GENEVA, 26 OCTOBER - Following the review of guidance on smallpox
vaccination I announced last week, WHO has consulted with our advi-
sory committee and has updated the official guidance.

The conclusion of the review states that:

"Existing vaccines have proven efficacy but also have a high inci-
dence of adverse side-effects. The risk of adverse events is suffi-
ciently high that mass vaccination is not warranted if there is no or
little real risk of exposure. Individual countries that have reason
to believe that their people face an increased risk of smallpox be-
cause of deliberate use of the virus are considering options for in-
creasing their access to vaccines. The vaccines would be given to
people who are at risk of exposure to smallpox, including health and
civil workers, and would be used in a search and containment exercise
should an out- break occur."

In summary, the guidance is that vaccination of entire populations is
not recommended. The reason for not recommending such mass vaccina-
tion is that there is a risk of severe reactions to the vaccine, in-
cluding death, and the fact that vaccination can prevent smallpox
even after exposure to the virus.

Up to now the guidance has also stated that only those with suspected
exposure to smallpox or a related virus should be vaccinated. That
has not changed.

What has changed is the increasing attention being given to the ex-
tent and quality of existing vaccine stocks, and to the possible need
both to stimulate vaccine production and increase stocks of vaccine
for use in the event of an outbreak.

WHO confirms that the best method of stopping a smallpox outbreak,
should it occur, remains the same search and containment. That means
identifying persons with smallpox, identifying those people who
have been in contact with them, and vaccinating them.

People who have been vaccinated in the past are unlikely to develop
the most serious effects of smallpox.

This advice and background information on smallpox is now being made
available to governments through the WHO website. Along with this ad-
vice we are providing:
* Frequently asked Questions and Answers about smallpox
http://www.who.int/emc/diseases/smallpox/faqsmallpox.html [2]
* A smallpox Fact Sheet:
http://www.who.int/emc/diseases/smallpox/factsheet.html [3]
* Training materials on smallpox, including: - An electronic slide
set of training materials on smallpox:
http://www.who.int/emc/diseases/smallpox/slideset/index.htm [4]
- WHO instructions for vaccine administration using the bifurcated
needle:
http://www.who.int/emc/diseases/smallpox/factsheet.html [3]
#Bifurcated and - WHO smallpox recognition card:
http://www.who.int/emc/diseases/smallpox/smallpoxrecognition.html [5]

Other information that will be provided to Health Ministers on re-
quest includes a list of vaccine manufacturers that have the poten-
tial to produce smallpox vaccine and the names of laboratories that
can diagnose smallpox. WHO has also re-established a team of techni-
cal experts in smallpox who are available to assist countries in the
investigation and response to outbreaks.

Finally, I want to emphasize that should an outbreak of smallpox be
detected in any country, this should be considered an international
emergency. WHO will help countries to pool available resources so as
to contain the disease as rapidly and effectively as possible.
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For more information, please contact
Dick Thompson,
Public Information Officer,
Communicable Diseases,
WHO, Geneva.
Tel: +41-22-791-2684.
mailto:[email protected] [6]
or
contact Office of the Spokesperson,
WHO, Geneva.
Tel: +41-22-791-2599;
Fax: +41-22-791-4858;
mailto:[email protected] [7]

All WHO Press Releases, Fact Sheets and Features
as well as other information on this subject can be obtained on
Internet on the WHO home page
http://www.who.int/ [8]

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