Recognizing Old Vaccine Scars

Do you have a scar on your arm and you aren’t sure why it is there?

Is it from the smallpox vaccine?

Recognizing Old Vaccine Scars

Classically, there are two vaccines that can leave a scar – the ones that protect us against smallpox and tuberculosis.

“BCG scar is a surrogate marker of vaccination and an important index in the vaccination program.”

Dhanawade et al on Scar formation and tuberculin conversion following BCG vaccination in infants: A prospective cohort study

And there are a few easy ways to tell if you have a smallpox scar.

When were you born? Remember, the smallpox vaccine hasn’t been used in the United States since the early 1970s and its use stopped everywhere in 1986.

And where were you born?

The BCG (bacille Calmette-Guerin) vaccine, on the other hand, is still in use in many countries, and is given at birth to prevent tuberculosis disease, including meningitis and disseminated tuberculosis. It isn’t routinely used in the United States though “because of the low risk of infection with Mycobacterium tuberculosis, the variable effectiveness of the vaccine against adult pulmonary TB, and the vaccine’s potential interference with tuberculin skin test reactivity.”

In general though:

• the BCG vaccine scar has a raised center
• the smallpox vaccine scar is depressed, with lines that radiate to the edges

Complicating matters is the fact that you can have multiple scars from each vaccine…

“In 1972, the National Advisory Committee on Immunization in Canada recommended that routine immunization of infants for smallpox be stopped. Very few Canadians born after 1972 have been immunized against smallpox. Those, like me, who were immunized prior to that date have little or no immunity left. Nothing, but a small scar as testimony to a grand global achievement.”

Diane Kelsall on A Small Scar

Do you have any vaccine scars?

More on Recognizing Old Vaccine Scars

• CDC – BCG Vaccine
• WHO – BCG vaccine
• Study – Scar formation and tuberculin conversion following BCG vaccination in infants: A prospective cohort study
• Study – The value of counting BCG scars for interpretation of tuberculin skin tests in a tuberculosis hyperendemic shanty-town, Peru
• Study – Smallpox vaccination site reactions: two cases of exaggerated scarring and a brief review.
• Study – Squamous cell carcinoma in situ arising in a smallpox vaccination scar.
• Failure of the Smallpox Vaccine To Develop a Skin Lesion in Vaccinia Virus-Naïve Individuals Is Related to Differences in Antibody Profiles before Vaccination, Not After
• A Small Scar
• Vaccination caveat. The off-the-shoulder look.
• Smallpox scars – the only evidence of an eradicated disease.
• Recognition of BCG Scars
• Vaccine Smarts – Scar on upper arm is from BCG vaccine
• The Round Scar Generation – How a Vaccine Defined a Generation
• A Scar Nobly Got
• A Taxonomy of Vaccination Scars