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International Notes Smallpox Vaccination

Following the global eradication of smallpox, the Thirty-Fourth World Health Assembly of the World Health Organization (WHO) by resolution amended the International Health Regulations to remove smallpox from the diseases subject to the Regulations, effective January 1, 1982 (1).

According to WHO, the collaboration of national health administrations in withdrawing the requirement for smallpox vaccination certificates has been very positive. All the countries of the world except Chad, in Africa, have advised WHO that an International Certificate of Vaccination against Smallpox is no longer required from any traveler. However, WHO reports that some local authorities in Democratic Kampuchea may require proof of vaccination. Because of the risk of complications of vaccination to both vaccinees and their contacts, physicians should give travelers to any country in which a certificate may be required a signed statement that vaccination is medically contraindicated. Smallpox vaccination should not be given for international travel. Reported by the Quarantine Div, Center for Prevention Svcs, and International Health Program Office, CDC.

Editorial Note

Editorial Note: The change in the International Health Regulations removes smallpox from the list of internationally quarantinable diseases and eliminates the legal basis for requirement of smallpox vaccination of international travelers.

A new revision of the International Certificates of Vaccination from which the smallpox vaccination certificate has been deleted will be available in the next several months.

In the United States, smallpox vaccination of civilians is recommended only if they are laboratory workers directly in contact with smallpox or other closely related orthopox viruses (2).

In 1981, the California Board of Medical Quality Assurance revoked the medical license of a physician who administered smallpox vaccine to a 53-year old man with chronic lymphocytic leukemia in an attempt to treat recurrent herpes labialis (3). The patient developed severe vaccinia necrosum. The California board stayed the revocation of the physician's medical license and placed him on probation for 5 years.

Smallpox vaccine is ineffective in the treatment of any disease.


  1. WHO. Smallpox vaccination certificates. Wkly Epidem Rec 1981;56:305.

  2. ACIP. Smallpox vaccine. MMWR 1980;29:417-20.

  3. California Department of Health Services. Inappropriate smallpox vaccination for recurrent herpes simplex--medical license revoked. California Morbidity 1981, November 20:45.

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