Did you know that having eczema is a contraindication to getting a vaccine?
Which vaccine?
The smallpox vaccine!
Yes, smallpox has been eradicated, but the vaccine is sometimes still used in very specific situations, especially in the military.
What is Eczema Vaccinatum?
Not only is eczema a contraindication to getting the smallpox vaccine, you shouldn’t even get it if a household contact has eczema.
Why not?
Yes, although anti-vaccine folks needlessly worry about shedding when kids get routine childhood vaccines and even talk about a shedding season, with the smallpox vaccine, problems with shedding are really a thing.
Since the smallpox vaccine is a live virus vaccine and since it very commonly causes a skin reaction at the injection site, shedding can spread it to others. While that’s a good thing with some vaccines, like the oral polio vaccine, because it increases herd immunity, it isn’t with the smallpox vaccine.
If the weakened smallpox vaccine can cause a skin reaction on your arm where you got the shot, what is it going to do if it gets on a child’s skin that is irritated all over with eczema?

It’s a good thing that we don’t routinely have to use the smallpox vaccine anymore.
“Because persons with eczema are deferred from vaccination, only a single, accidentally transmitted case of EV has been described in the medical literature since military vaccination was resumed in the United States in 2002.”
Reed et al on Eczema vaccinatum.
And that it doesn’t happen with any other vaccines!
More on Eczema Vaccinatum
- VAXOPEDIA – Should I Be Worried That My Kids Didn’t Get the Smallpox Vaccine?
- VAXOPEDIA – Recognizing Old Vaccine Scars
- VAXOPEDIA – Vaccinated vs Unvaccinated – Smallpox Edition
- VAXOPEDIA – The Leicester Method and Smallpox Eradication
- VAXOPEDIA – The Plano Smallpox Outbreak of 1895
- VAXOPEDIA – Which Vaccines Do You Get When You Join the Military?
- VAXOPEDIA – Which Vaccine Is the Most Dangerous?
- Images in clinical medicine. Eczema vaccinatum–a timely reminder.
- Eczema vaccinatum.
- MMWR – Smallpox Surveillance — Worldwide (1978)
- CDC – History of Smallpox
- CDC – Contraindications to Smallpox Vaccination
- MMWR – Use of Vaccinia Virus Smallpox Vaccine in Laboratory and Health Care Personnel at Risk for Occupational Exposure to Orthopoxviruses — Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2015
- MMWR – Smallpox Vaccination and Adverse Reactions
- CDC – Smallpox Vaccines
- WHO – Smallpox
- CDC Interim Guidance for Revaccination of Eligible Persons Who Participated in the US Civilian Smallpox Preparedness and Response Program