This volunteer smallpox eradication team vaccinator was in the process of administering a vaccine to a woman who was obtaining water from a local well. The vaccine is not given with a hypodermic needle, but given using a bifurcated (two-pronged) needle that has been dipped into the vaccine solution. When removed, the needle retains a droplet of the vaccine. The needle is used to prick the skin a number of times in a few seconds. The pricking is not deep, but it will cause a sore spot, and one or two droplets of blood to form. The vaccine usually is given in the upper arm. If the vaccination is successful, a red and itchy bump develops at the vaccine site in three or four days. In the first week, the bump becomes a large blister, fills with pus, and begins to drain. During the second week, the blister begins to dry up and a scab forms. The scab falls off in the third week, leaving a small scar. First-time vaccinees have a stronger reaction than those who are being revaccinated.
CDC/ World Health Organization; Stanley O. Foster M.D., M.P.H.
December 4, 2012
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