Smallpox vaccination with ACAM2000: Introduction,
with Dr. Brett Petersen.
The eradication of smallpox was one of the greatest achievements
in the history of medicine and public health.
Unfortunately, smallpox remains a threat
because of its potential use as a biological weapon.
This training video will assist healthcare workers
and vaccine administrators to become familiar
with the ACAM2000 smallpox vaccine; the techniques used
for its administration; vaccination site care and ways
to prevent the spread of live vaccinia virus; common reactions
and potential serious adverse events following vaccination;
and how to screen potential vaccinees for contraindications
to vaccination when a smallpox emergency is in effect
and when it is not in effect.
Thank you for your participation
in this important public health activity.
ACAM2000 is approved by the United States Food
and Drug Administration, the FDA, for active immunization
against smallpox disease for individuals determined to be
at high risk for smallpox infection.
Although this training video focuses on ACAM2000,
there are two additional smallpox vaccines maintained
in the CDC Strategic National Stockpile, or SNS.
These vaccines are the Aventis Pasteur Smallpox Vaccine,
or APSV, and Imvamune.
Both vaccines are available from the SNS in limited quantities
and would be deployed under the appropriate regulatory mechanism
for investigational products.
None of these three smallpox vaccines contain smallpox
or the variola virus.
Instead, these vaccines contain strains of the vaccinia virus,
which is highly effective
in immunizing individuals against smallpox.
ACAM2000 and APSV vaccines contain live virus
from the New York City Board of Health strain of vaccinia virus
and are replication-competent vaccines
since they still have the ability
to replicate in mammalian cells.
Similar replication-competent vaccines have been shown
to confer rapid protection against smallpox
and have been used successfully in outbreak settings
and during the worldwide smallpox eradication campaign.
However, replication-competent vaccines have historically been
associated with serious vaccine adverse events
and active vaccination lesions are considered infectious
until the scab falls off.
In contrast, Imvamune is a replication-deficient vaccine
and contains the Modified Vaccinia Ankara Virus, or MVA.
MVA is an attenuated strain of live vaccinia virus
that has lost its ability to replicate fully
in mammalian cells; thereby potentially reducing the risk
for serious adverse events related
to dispersed vaccinia infection and transmission
of the vaccine virus from vaccinees to close contacts.
Imvamune is given subcutaneously as an injection
in a two-dose series given 4 weeks apart
and does not elicit a visible cutaneous response
following vaccination.
Imvamune will be made available during a smallpox emergency
under an FDA emergency use authorization, or EUA,
for individuals with HIV infection and atopic dermatitis.
The training video is divided into 6 chapters
and two appendices: Chapter 1: Introduction Chapter 2:
Description and preparation of the ACAM2000 smallpox vaccine,
administration technique using a bifurcated needle,
and description of a "vaccine take" Chapter 3: Instructions
on how to care for the smallpox vaccination site and how
to prevent the spread of vaccinia virus Chapter 4:
Common reactions and potential serious adverse events following
smallpox vaccination Chapter 5:
(Pre-event) Screening individuals for vaccination
when there is no smallpox emergency Chapter 6:
(Post-event) Screening individuals
for vaccination during a smallpox emergency
and Appendices that include more detailed information
on APSV and Imvamune