Who Should Not Get the Smallpox Vaccine?
Smallpox vaccination may cause heart inflammation that can be mild to life-threatening. It is not known who is at risk for this problem. As a precaution, anyone who has been told by a doctor that they have a heart condition should not get the smallpox vaccine, even if they feel well. This includes anyone who has:
- Known heart disease, such as past heart attack or angina (chest pain caused by lack of blood to the heart)
- Congestive heart failure
- Cardiomyopathy (heart muscle becomes enlarged and does not work as well as it should)
- Stroke or transient ischemic attack (a "mini-stroke" that causes stroke-like symptoms, but no lasting damage)
- Chest pain (angina) or shortness of breath with activity (such as walking up stairs)
- Other heart conditions that require the care of a doctor.
In addition, if you have 3 or more of the following risk factors, you should not get the smallpox vaccine:
- You have been told by a doctor that you have high blood pressure
- You have been told by a doctor that you have high blood cholesterol
- You have been told by a doctor that you have diabetes or high blood sugar
- You have a first-degree relative (for example, mother, father, sister, or brother) who had a heart condition before the age of 50
- You smoke cigarettes now.
Babies of mothers who have been vaccinated while pregnant or during the month before they became pregnant can get a very rare but serious infection from the smallpox vaccine.
Do not get the smallpox vaccine if you are pregnant, think there is a chance you are pregnant, or think you might become pregnant within 4 weeks after vaccination.
Sexually active women are encouraged to take a pregnancy test before getting the vaccine. The test should be done the day their vaccination is scheduled. However, be aware that even the best tests may not detect early pregnancies (those less than 2 weeks).
Take steps to prevent pregnancy during the month before and the month after vaccination by either:
- Abstaining from sex.
- Using effective birth control every time you have sex. Effective birth control methods include male or female sterilization, hormonal methods (such as birth control pills, implants, patches, or injections), and intrauterine devices (IUDs). Condoms and the use of spermicide with diaphragms, sponges, or cervical caps are also acceptable methods, although they are less effective. Do not rely solely on the rhythm or natural family planning method.
Do not get the smallpox vaccine if you are breastfeeding. Follow this advice even if you are pumping and then bottle-feeding breast milk. It is not known if smallpox vaccine virus or antibodies can be passed to babies through breast milk.