Roseola vaccinia
| Roseola vaccinia | |
|---|---|
| This child was subsequently diagnosed with roseola vaccinia. | |
| Specialty | Dermatology |
Description
Roseola vaccinia, also known as generalized vaccinia, erythema vaccinatum ,or vaccine-associated smallpox rash, is a cutaneous condition characterized by a sudden eruption of a rash following the smallpox vaccination injection.
Etiology and pathophysiology
Roseola vaccinia has been suggested to be a hypersensitive, benign reaction to the smallpox vaccination.
Roseola vaccinia should be distinguished from other skin complications from the smallpox vaccination including erythema multiforme, Stevens–Johnson Syndrome, eczema vaccinatum, toxic erythema, and postvaccinia urticaria based on cutaneous appearance and severity with systemic involvement.[1]
Epidemiology
Roseola vaccinia is considered a rare complication with approximately 23.4–238.2 cases per million primary vaccinees historically when the smallpox vaccination was administered.[2]
Clinical diagnosis and features
Roseola vaccinia is diagnosed clinically based on history of recent smallpox immunization with observation of the characteristic rash. Laboratory tests or biopsies are rarely indicated for diagnosis. Roseola vaccinia often manifests within two weeks of vaccine administration and lasts three to four days. The rash may be diffuse, maculopapular, erythematous rash distributed over the trunk, limbs, or face or a collection of lesions present at the immunization injection site. Other symptoms associated with the rash include fever and fatigue.[3]
Management
Treatment and management of the vaccination complication is generally supportive as the rash is self-limiting and will resolve without extensive interventions.
History of smallpox vaccination
The smallpox vaccination is a live vaccination derived from the vaccinia virus, which is a viral family of poxvirus. The smallpox vaccination does not carry any variant of the smallpox virus, the variola virus. The smallpox vaccine is no longer recommended for the general public and no longer considered a routine vaccination for children due to the global eradication of smallpox in 1980. The vaccine is available only through the Centers for Disease Control and Prevention and will be distributed in the setting of a smallpox outbreak.[2]
References
Annunziato D. Smallpox vaccination: a personal perspective on an imperfect essential. Contemporary Pediatrics. 2003;20:62. Available at: https://www.contemporarypediatrics.com/view/smallpox-vaccination-personal-perspective-imperfect-essential-0.
Brownstein MH, Datlof P. Roseola vaccinia. Archives of Dermatology. 1968;97(4):422–424.
Cono J, Casey CG, Bell DM. Smallpox vaccination and adverse reactions: guidance for clinicians. MMWR Recomm Rep. 2003;52(RR-4):1–28. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5204a1.htm.
Wittek R. Vaccinia immune globulin: current policies, preparedness, and product safety and efficacy. International Journal of Infectious Diseases. 2006;10(3):193–201. doi:10.1016/j.ijid.2005.12.001.
See also
References
- ^ Brownstein, Martin H. (1968-04-01). "Roseola Vaccinia". Archives of Dermatology. 97 (4): 422. doi:10.1001/archderm.1968.01610100062009. ISSN 0003-987X.
- ^ a b "Smallpox Vaccination and Adverse Reactions". www.cdc.gov. Retrieved 2026-03-15.
- ^ "Smallpox Vaccination and Adverse Reactions". www.cdc.gov. Retrieved 2026-03-15.