Bulletin No. 10
May 23, 1980
Smallpox Vaccine Discontinued
Effective immediately the Section of Communicable Disease Control will no longer provide smallpox vaccine to private and public health care providers. It has now been over 30 months since the world's last reported case of endemic smallpox occurred in Somalia in October, 1977. In December, 1979, the WHO's Global Commission for the Certification of Smallpox Eradication certified that the world was smallpox-free. On January 25, 1980, the WHO Executive Board endorsed this conclusion as well as several recommendations including:
2. An international certificate of vaccination against smallpox shall no longer be required of any traveler.
Despite these WHO conclusions, as of May 14, 1980, the following 11 countries still require smallpox vaccination of travelers from the United States:
2. Africa: Benin (if travelers stay 2 weeks), Cameroon, Chad, Djibouti, Lesotho, Madagascar, Mali, Upper Volta, Zimbabwe (if traveler stays 3 months)
Of particular importance to Alaska is that the Philippines no longer requires a smallpox vaccination.
There is no accepted medical indication for smallpox vaccination except to protect individuals from acquiring smallpox. For a small number of individuals working with smallpox virus in controlled laboratory environments vaccination remains important. However, for the vast majority of travelers the risk of complication secondary to smallpox vaccination is greater than the risk of acquiring smallpox. Hospital employees, of course, should not receive routine smallpox vaccinations.
For these reasons we no longer feel it necessary to supply smallpox vaccine. For those occasional individuals who travel to any of the 11 remaining countries still requiring smallpox vaccination, we recommend that a private physician provide a "vaccination waiver" letter stating that the traveler has a medical contraindication to smallpox vaccination. We have been recommending this procedure since May, 1979, and have received no word of difficulty from travelers using these letters. When necessary, this office will supply such a letter only to travelers visiting countries still requiring vaccination.
Health care providers will be notified simultaneously by letter of this decision to not supply smallpox vaccine and will be asked to return unused smallpox vaccine. Similarly, we will request that the use of or distribution of smallpox vaccine by Division of Public Health personnel cease.
For information regarding updated changes in countries requiring smallpox vaccination or to discuss this change in policy, please call the Section of Communicable Disease Control at 272-7534.