Details:

Journal Article:
HAN
Corporate Authors:
Centers for Disease Control and Prevention (U.S.) ; United States. Advisory Committee on Immunization Practices.
Centers for Disease Control and Prevention (U.S.) ; United States. Advisory Committee on Immunization Practices. Less -
Description:
Tuesday, April 01, 2003, 16:21 EST (4:21 PM EST)

CDCHAN -00134-03-04-01 ADV-N

The AC IP held an emergency meeting by conference call on Friday, March 28, 2003, to make recommendations to CDC regarding cases of cardiac adverse events that have been reported following smallpox vaccination, including myocarditis and/or pericarditis, myocardial infarction, and angina.

The available data suggest that smallpox vaccine can cause myocarditis and/or pericarditis. However, the number of cases of angina and myocardial infarction reported are compatible with the expected background rate. This means that observed angina and heart attack cases may have a coincidental rather than a causal relation to the vaccine. Nevertheless, as a precautionary measure, it is prudent to defer vaccination at this time of persons most at risk for heart attacks and angina, independent of vaccination.

Therefore, the AC IP recommended that persons be excluded from the pre-event smallpox vaccination program who have been diagnosed as having a heart condition or ischemic cardiovascular condition, with or without symptoms (such as previous myocardial infarction, angina, congestive heart failure, cardiomyopathy, stroke or transient ischemic attack, or other heart conditions under the care of a doctor). The Committee also recommended that persons be excluded if they have three or more known major cardiac risk factors including hypertension, diabetes, hypercholesterolemia, and smoking. After consulting with experts in cardiology, CDC added to this the additional risk factor of having an immediate family member who has had onset of a heart condition before age 50. The Committee supported including the risk factors in pre-vaccination clinic education materials, so potential vaccinees could evaluate their risk status with their personal physician prior to presentation for vaccination if they had concerns; at the vaccination clinic, verbal screening for known risk factors was recommended.

The Committee did not recommend special medical follow-up for persons with cardiovascular risk factors who had been vaccinated. Persons with risk factors or known atherosclerotic coronary artery disease should be cared for by their physicians in accordance with standard guidelines for treatment and control of these conditions.

CDC has accepted the ACIP recommendations and has revised and distributed fact sheets and pre-vaccination clinic education and screening materials that reflect the new exclusion criteria. These revised forms, dated March 31 2003, replace previously distributed versions and should be used immediately in smallpox vaccination clinics. The materials are available at www.cdc.gov/smallpox.


Subjects:
[+]
Myocarditis/etiology Pericarditis/etiology Smallpox Vaccine/adverse Effects Vaccination/adverse Effects
Series:
HAN ; 134
Document Type:
HAN Health Update
Place as Subject:
United States
Location:
North America
Collection(s):
Advisory Committee on Immunization Practices (ACIP) Health Alert Network (HAN)
Main Document Checksum:
[+]
urn:sha256:004f5424e2362a1faad9a7e4c0fd93ad25e66afbad27e5317a0cac8542583cd5
Download URL:
https://stacks.cdc.gov/view/cdc/25046/cdc_25046_DS1.pdf
File Type:

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