Orthopoxvirus Vaccines

Covered: pre‑exposure smallpox (orthopoxvirus) vaccination is allowed when public health authorities advise and is limited to ACIP‑recommended groups (laboratory workers handling non‑highly attenuated virus, persons pre‑designated to investigate/treat initial cases, and selected referral‑center personnel); vaccination of the general population is excluded and most plans also exclude vaccines required for work/travel. Key requirements/limitations: the CDC is the sole source of vaccinia vaccine and vaccinia immunoglobulin, tuberculin skin testing should be deferred for 4 weeks post‑vaccination, and breastfeeding is a contraindication.

"Pre-exposure immunization with orthopoxvirus (smallpox) vaccine as a preventive service in instances where public health authorities advise that such vaccination is necessary."

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