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Accidental implantation vaccinia - Skin in Child
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Accidental implantation vaccinia - Skin in Child

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Contributors: Sarah Stein MD, Karen Wiss MD, Sheila Galbraith MD, Craig N. Burkhart MD, Dean Morrell MD, Lynn Garfunkel MD, Nancy Esterly MD
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Synopsis

Transfer of vaccinia (smallpox vaccine) – a live and highly dermatotrophic virus – from the vaccination site to the skin and mucosa is a common adverse event of smallpox vaccination, due to a child's tendency to scratch the vaccination site that contains the live vaccinia virus. Accidental implantation may also occur from handling the gauze or other materials that cover or come in contact with the vaccination site.

Transfer can be by autoinoculation or by contact with a recent vaccinee. Accidental implantation may vary from a single lesion or multiple lesions to massive involvement of disruptive skin in children with eczema, acne, skin disorders with open lesions, and inflammatory eye diseases.

In individuals with cell-mediated immune defects, the implantation can be serious and life threatening and lead to progressive vaccinia.

Children are most susceptible to more extensive inoculations because of their propensity to scratch the vaccination site.

The Advisory Committee on Immunization Practices (ACIP) advises that infants aged younger than 12 months not get the smallpox vaccine. In addition, the ACIP advises against nonemergency use of smallpox vaccine in children aged younger than 18 years.

Codes

ICD10CM:
T88.1XXA – Other complications following immunization, not elsewhere classified, initial encounter

SNOMEDCT:
409637001 – Inadvertent inoculation with vaccinia virus following contact with smallpox vaccination site

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Last Updated: 07/16/2018
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Accidental implantation vaccinia - Skin in Child
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Accidental implantation vaccinia : Individual recently immunized with vaccinia, Scattered few, Umbilicated vesicle
Clinical image of Accidental implantation vaccinia
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