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Routine childhood inoculation with smallpox vaccine, which is made from live vaccinia virus, was discontinued in the U.S. in 1972 because the risk for severe reactions to the vaccine was deemed to outweigh the risk for acquiring smallpox. These reactions included encephalitis, generalized vaccinia, and — in immunocompromised individuals — progressive vaccinia (PV; unchecked necrosing lesions at the vaccination site). In 2002, because of concern about bioterrorist use of remaining smallpox stocks, the military reintroduced smallpox vaccination; the following year, a voluntary vaccination program began for healthcare workers who might be first responders. The CDC now reports the first confirmed case of PV in the U.S. since 1987.
On January 13,…