Vaccine “Take” Evaluation
A “take” or “major cutaneous reaction” indicates successful vaccination. A normal take will show a pustular lesion or an area of definite induration or congestion surrounding a central lesion, which can be a scab or an ulcer. Anything else is considered a “non-take.”
Non-takes can be caused by improper vaccination technique, use of vaccine that has lost its potency, or residual vaccinial immunity among previously vaccinated persons. Do not presume a person with a non-take to be immune to smallpox. Revaccinate anyone with a non-take reaction using a different vaccine lot.
Evaluate the vaccine site for both first-time vaccinees and revaccinees on the 6th, 7th, or 8th day following vaccination. Vaccine site evaluations on other days may not be reliable.
Examples of “takes”
The three images below both clearly demonstrate a central lesion.
See additional images of Examples of Major or “Take” Reactions to Smallpox Vaccination
Examples of “non-takes”
See additional images of Comparison of Reactions for Primary Vaccines and Revaccinees
Smallpox Vaccination and Adverse Reactions: Guidance for Clinicians Source: MMWR 2003, 52(RR04);1-28.
Surveillance Guidelines for Smallpox Vaccine (vaccinia) Adverse Reactions, 2006 Source: MMWR 2006, 55(RR01);1-16.