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Woman contracted vaccinia virus, the chief ingredient in the vaccine, through sex, CDC report says
After engaging in a sexual activity with a soldier who recently received a smallpox vaccine, a young lady in the state of Washington became ill as a result of infection with vaccinia virus used in the shot, according to health officials in the United States.
 Although this type of viral transmission occurs rarely, it is not quite astonishing, officials at the U.S. Centers for Disease Control and Prevention (CDC) said.
"The patient visited an urgent care clinic with painful, ring-shaped vaginal swelling," said Andrea McCollum, an Epidemic Intelligence Service Officer with the CDC. A few days prior to that visit, the woman had sexual contact with her soldier boyfriend who recently received a smallpox vaccine through the military, McCollum explained.
As a precautionary measure against the potential use of the virus as a weapon in a biological assault, U.S. military personnel have been recipients of the vaccine in the past few years even though smallpox is almost eliminated at present. According to McCollum, the smallpox vaccine is given in the form of a live vaccine, thus a certain amount of infection risk is always present. She emphasized that the vaccine does not contain smallpox virus, but it contains vaccinia virus, which is a close relative of the smallpox virus.
The report said that in spite of the woman’s suggestion that she was probably exposed to smallpox vaccine through sexual activity with her boyfriend who was a recent recipient of the shot, the doctor did not test her for vaccinia, but only for common sexually transmitted diseases (STDs). The report appears in the July 1 issue of the CDC journal Morbidity and Mortality Weekly Report.
Even though the woman took the antibiotics and antiviral drugs prescribed by the doctor, the lesions and pain she experienced persisted for the next three days, said McCollum.
After consultation with another doctor, she was then referred to an infectious disease specialist who established that she was infected with the vaccinia virus.
Compared to smallpox, vaccinia infection is rather mild, and there was no specific treatment needed to treat the woman. However, the patient did experience some pain, soreness and irritation, which soon disappeared, McCollum said.
But McCollum added that they were very much worried that the woman might spread the virus to her household contacts, because one of her roommates was a kidney transplant recipient. The transplant recipient was immunosuppressed and was taking a number of medications. McCollum said that an infection with vaccinia virus especially in a person whose immune system is suppressed, "can be very serious and life-threatening."
There have been reports of other cases of people contracting this infection through contact with individuals who recently received a smallpox vaccine, McCollum noted. AT CDC, she said, they are not aware of every case of vaccinia virus infection that occurs.
With the inclusion of this case, the CDC knows about five similar cases happening over the past year, according to McCollum. She added that all the cases involved women who presented with lesions in their genital area, and who had recently engaged in a sexual activity with smallpox-vaccinated military personnel.
Aside from the military personnel, other people who receive the vaccine include some health care providers and laboratory personnel whose work involves dealing with the virus, said McCollum.
When it comes to immunizations in general, she said that the risk of spreading a virus through a recent vaccination is present with vaccines containing a so-called live virus. She said that majority of the present vaccines -- including most flu vaccines and those given to children -- are made from the deactivated virus, and therefore do not pose such hazard.
Because a smallpox vaccine contains a live virus, receiving a shot leaves you infectious from the vaccination site for a period of about two to three weeks, and so you need to take careful measures to cover it, according to infectious disease specialist Dr. Marc Siegel, an associate professor of medicine at New York University in New York City.
Siegel said that another live-attenuated vaccine is the oral polio vaccine, which has been implicated to cause polio in extremely unusual instances.
Nevertheless, the wide array of vaccines contain killed virus so this does not pose an issue with them, he repeated. The flu vaccine which is inhaled is an exception, he said, adding that you could spread influenza in a much weakened form to someone who is immunocompromised, "But vaccinia is more infectious than that," Seigel said.
This serves as a reminder that vaccines containing live viruses -- which are increasingly being misused -- "carry their own risk of minor infection and should not be used in immunocompromised people."
In truth, vaccines with live virus have one advantage, in the sense that the immune response they generate is stronger compared to that of vaccines containing killed virus, Seigel added.
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