From Ankeny, Iowa, USA:
If my son, who has type 1 diabetes, needs to get a smallpox vaccination, I need to convince him to do so. The only way I can do that is with hard statistics. Do you have statistics showing results of administering the smallpox vaccination to people with type 1 diabetes in the early 50s, 60s or 70s? What are the complications?
The plan at present is not to immunize any children against smallpox unless there is an outbreak. Overall, the odds of having a "serious reaction" to the smallpox vaccine is about 1:70,000. It is my understanding that this does not appear to be changed by the presence of diabetes. Reactions are, however, felt to be more likely in persons with eczema or other skin conditions.
Additional comments from Dr. Donough O'Brien:When routine smallpox vaccination was discontinued in the U.S. some thirty years ago, it was felt that the dangers of complications exceeded the likelihood of getting the disease. Children with disorders like agammaglobulinemia were at special risk, but the incidence of encephalitis, the most serious complication was overall about 1:110,000, and the mortality was around 50%. In a terrorist engendered outbreak there would be a shortage of hyperimmune gamma globulin and essentially no experience of the value of anti viral drugs.
Children with type 1A (autoimmune) diabetes would not be specially vulnerable to infection, but if infected, would risk DKA [diabetic ketoacidosis]. Our advice would still be to not vaccinate unless a specific threat developed.
Original posting 23 Dec 2002
Posted to Other Medications
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