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While hopefully smallpox vaccination will never be a concern for most people, now’s a good time for everyone to start researching the topic. This is especially true since bellicose Russia controls one of the only two places in the world known to have smallpox virus, the VECTOR facility. The other one is the US CDC.

Unlike the Covid-19 vaccines, smallpox vaccination has a very long history. So, it should be easier to evaluate the risks vs. benefits, though third generation vaccines are supposed to be safer. For a quarter of a century, school children in the United States were unnecessarily required to take the original, dangerous, vaccine. The good news is that those who were previously vaccinated should have some level of immunity against monkeypox, as well as immunity against smallpox. Also, individuals can be vaccinated post-exposure. The last major US smallpox outbreak was in NYC in 1947. It was caused by a rug merchant who went to Latin America and came back with smallpox. Only two people died. Why wasn’t he simply told to get the smallpox vaccine before he traveled? https://en.wikipedia.org/wiki/1947_New_York_City_smallpox_outbreak Instead, this was used as an excuse to vaccinate very young children all over the United States up until 1973, despite the serious risks associated with the vaccine. With the smallpox vaccine, available at the time, it was known that post-exposure vaccination could work. So, why were young children vaccinated in areas that had no smallpox for a very long time, if at all, given that the smallpox vaccine was long known to be dangerous? Why were no warnings given to the public, either?

The newer Jynneos vaccine is supposed to be safer, than the earlier vaccine: https://patents.google.com/patent/US7923017B2/en And, no, it’s NOT an mRNA vaccine, it’s an “attenuated virus which is derived from Modified Vaccinia Ankara virus and which is characterized by the loss of its capability to reproductively replicate in human cell lines”, i.e. it is a “non-replicating smallpox vaccine”.

The individuals in this study almost certainly received the original vaccines, because it’s from 2008.
Excerpts from NIH Public Excerpt Author Manuscript:
Immunity from Smallpox Vaccine Persists for Decades: A Longitudinal Study Published in final edited form as: Am J Med. 2008 December; 121(12): 1058-1064. By Dennis D. Taub, PhDa, William B. Ershler, MDa, Mark Janowski, MDa, Andrew Artz, MDa, Michael L. Keya, Julie McKelveya, Denis Muller, MSa, Bernard Moss, MD, PhDb, Luigi Ferrucci, MD, PhDa, Patricia L. Duffeya, and Dan L. Longo, MDa
aLaboratory of Immunology and the Clinical Research Branch, National Institute on Aging— Intramural Research Program, National Institutes of Health, Baltimore, Md
bLaboratory of Viral Diseases, National Institute of Allergy and Infections Disease—Intramural Research Program, National Institutes of Health, Bethesda, Md.

• Vaccinia elicits antiviral antibody levels and virus neutralizing activity that remain elevated for the life of the patient.
• Multiple vaccinations achieve only marginally higher levels of antibody and virus neutralizing activity than single vaccination.
• Levels of antibodies and virus neutralizing activity are comparable in vaccinated individuals and those who developed smallpox and recovered.
• Vaccinia should be used first on individuals who have never been vaccinated before.

PURPOSE—The threat of smallpox resulting from bioterrorist action has prompted a reassessment of the level of immunity in current populations.

METHODS—We have examined the magnitude and duration of antiviral antibody immunity conferred by smallpox vaccination in 246 participants of the Baltimore Longitudinal Study of Aging. Of this population, 209 subjects were vaccinated one or more times 13 to 88 years before this evaluation, and stored serum samples were available at various intervals after vaccination. An additional 8 subjects who had documented childhood smallpox infection and 29 subjects with no history of infection or vaccination were included. We quantified the total vaccinia IgG and neutralizing antibody titers in each of these subgroups of participants over time.

RESULTS—Vaccinated participants maintained antivaccinia IgG and neutralizing antibody titers above 3 natural logs essentially indefinitely. The absolute titer of antivaccinia antibody was only slightly higher after multiple vaccinations. In 97% of the participants, no decrease in vaccinia-specific antibody titers was noted with age over a follow-up period of up to 88 years. Moreover, Baltimore Longitudinal Study of Aging participants who survived active smallpox infections in their youth retained antivaccinia antibody titers that were similar to the levels detected in vaccinated subjects.

CONCLUSION—These data suggest that multiple or recent vaccinations are not essential to maintain vaccinia-specific antibody responses in human subjects. Scarce vaccine supplies should be applied first to individuals who have not previously been vaccinated.

Aging; BLSA; Biodefense; Smallpox; Vaccination; Vaccinia

The vaccinia virus vaccine has been used to prevent smallpox disease and control its spread since the late 18th century. Routine vaccination with vaccinia was discontinued over 30 years ago in many countries.1-8 Despite the worldwide eradication of smallpox in 1977, the potential re-emergence of this disease from bioterrorist action has prompted international health care authorities to reassess the level of immunity in current populations and to evaluate the risks and benefits of revaccination programs…

In the past, primary vaccination of individuals with vaccinia was believed to confer dependable protection for at least 5 years, with increasing protection achieved with subsequent revaccinations.1,2 However, a major question posed today is whether those individuals vaccinated 40 or more years ago would be protected in the event of smallpox exposure. This may be a critical question because the availability of smallpox vaccines is limited and currently inadequate for a mass inoculation program.

To address this, we evaluated the stability and potency of vaccinia-specific immunity after smallpox vaccination in 209 individual participants in the National Institute on Aging’s Baltimore Longitudinal Study of Aging. Longitudinal studies have an advantage over cohort studies in allowing multiple measures in an individual over time…

With the extinction of naturally occuring smallpox, it may be impossible to definitively establish the immunological correlates of protection against this disease in humans. Based on older data,11 the 1:32 titer is a reasonable biomarker of protective immunity. Our results demonstrated that >97% of the samples tested exhibited neutralization titers above 1:32 at all time points tested. Less than 1% of the donors demonstrated titers initially above 1:32 that subsequently fell below this cutoff value.

Similarly, as subjects previously diagnosed with smallpox possess lifelong protection against the smallpox virus,11-21 we also have used as a threshold the lowest neutralization titer from the 8 BLSA participants with documented medical histories of smallpox infections. This titer was found to be 1:48. Using this level of neutralizing antibody as a marker for smallpox resistance, we found that 95% of the subjects demonstrated titers above this level for all samples examined…

Individuals who have survived a smallpox infection are thought to maintain lifelong protection; by contrast, vaccination generally induces a response that diminishes over time. Thus, we expected that individuals with a history of infection would have higher levels of immunity than those who were vaccinated. However, we found that vaccinia-specific antibody titers were comparable in these 2 groups (Figure 3). The mechanism of the lifelong persistence of vaccinia-elicited smallpox immunity is undefined.

The morbidity associated with vaccine administration and the risk of mortality among elderly and immune-compromised populations also are critical factors that will influence a vaccination policy. Little information is available about the safety and efficacy of smallpox vaccines in elderly populations. Furthermore, the aging process is associated with immune responses abnormalities.28-30 Development of immunization guidelines for the population will need to consider these factors.

Protecting the population against smallpox in the face of limited supplies of vaccine may be a challenge. Frey et al 31 have shown that 1:10 dilutions of the vaccine also are highly efficient at eliciting clinical takes in previously unvaccinated individuals. Our [research] revealed that nearly all the individuals who have been vaccinated one or more times maintained antivaccinia IgG and neutralizing antibody titers above 3 natural logs indefinitely. Titers were stable for up to 88 years. Moreover, those who survived active smallpox infections in their youth retained vaccinia-specific immunity throughout their lives and their antivaccinia antibody titers were similar to the levels of vaccinated subjects. Thus, vaccinated subjects remain immune to vaccinia indefinitely and do not require booster vaccinations even if they are many decades removed from primary vaccination. These data imply that limited supplies of vaccine can be more usefully applied (perhaps in diluted form) to individuals who have never been vaccinated, primarily individuals born after 1972


We thank Drs. Anthony Fauci and David Schlessinger for their helpful comments and careful review of this manuscript. In addition, we thank Dr. Dorothy Scott (CBER/FDA) for her assistance in obtaining the VIG reference standard.

Funding: This research was supported by the Intramural Research Program of the National Institute on Aging. National Institutes of Health…https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2610468/pdf/nihms-80700.pdf

NB: The original text read “Our revealed…”, so research was added in brackets: “Our [research] revealed…”

Note that Jynneos/MVA-BN is supposed to be safer than the older vaccines, and has been ordered for the emergency strategic stockpile: United States Patent (10) Patent No.: US 7.923,017 B2 Chaplin et al. (45) Date of Patent: *Apr. 12, 2011 “The present invention provides an attenuated virus which is derived from Modified Vaccinia Ankara virus and which is characterized by the loss of its capability to reproductively replicate in human cell lines. It further describes recombinant viruses derived from this virus and the use of the virus or its recombinants as a medicament or vaccine. Additionally, a method is provided for inducing an immune response even in immune-compromised patients, patients with pre-existing immunity to the vaccine virus, or patients undergoing antiviral therapy.“ https://patents.google.com/patent/US7923017B2/en
jynneos https://www.fda.gov/media/131078/download
acam 2000 https://www.fda.gov/media/75792/download

See too (Go to original for embedded links): https://www.fda.gov/emergency-preparedness-and-response/mcm-issues/smallpox-preparedness-and-response-updates-fda* May 18, 2022: FDA approved an intravenous (IV) formulation (PDF, 565 KB) of TPOXX (tecovirimat) to treat smallpox. The oral formulation of the drug was originally approved in 2018. The IV formulation is an option for those who are unable to swallow the oral capsule. Also see Therapeutics below
* June 4, 2021: FDA approves drug to treat smallpox – FDA approved Tembexa (brincidofovir) to treat smallpox. Although the World Health Organization declared smallpox, a contagious and sometimes fatal infectious disease, eradicated in 1980, there have been longstanding concerns that the virus that causes smallpox, the variola virus, could be used as a bioweapon. 
* November 15, 2019: FDA In Brief: FDA issues final guidance for development of smallpox treatments as part of critical preparedness efforts – FDA issued final guidance, Smallpox (Variola Virus) Infection: Developing Drugs for Treatment or Prevention (PDF, 127 KB), which is designed to assist drug manufacturers designing studies to appropriately establish the safety and efficacy of drugs to treat or prevent smallpox infection. Also see Guidance for industry below
* September 24, 2019: FDA announced the approval of Jynneos Smallpox and Monkeypox Vaccine, Live, Non-Replicating, for the prevention of smallpox and monkeypox disease in adults 18 years of age and older determined to be at high risk for smallpox or monkeypox infection. This is the only currently FDA-approved vaccine for the prevention of monkeypox disease. Jynneos will be available for those determined to be at high risk of either smallpox or monkeypox infection. This vaccine is also part of the Strategic National Stockpile (SNS), the nation’s largest supply of potentially life-saving pharmaceuticals and medical supplies for use in a public health emergency that is severe enough to cause local supplies to be depleted. The availability of this vaccine in the SNS will help ensure that the vaccine is accessible in the U.S. if needed.
Fast Facts
* Variola virus is the causative agent of smallpox. 
* Smallpox was declared eradicatedExternal Link Disclaimer
 in 1980 by the World Health Organization, with no known cases of naturally occurring smallpox having occurred since 1977. The last outbreak of smallpox in the United States occurred in 1949.
* While there is no known immediate, direct threat of a biological attack using smallpox (i.e., an intentional release of Variola virus), concerns over the possible use of Variola virus in a biological attack have led to increased preparedness efforts.
* Transmission:Smallpox can be transmitted person-to-person via inhalation of virus-containing airborne droplets of saliva from an infected person. Transmission can also occur via contact with material from the smallpox pustules or crusted scabs, or through materials such as bedding or clothing that has been in contact with the pustules or scabs.
* Prevention: Smallpox can be prevented by vaccination with smallpox vaccine. The vaccine does not contain the smallpox virus and cannot give you smallpox. Also see Vaccines below
* Treatment: Treatment of patients with smallpox generally involves supportive care. TPOXX (tecovirimat) and Tembexa (brincidofovir) are approved for the treatment of smallpox. Also see Therapeutics below
” Read and see links: https://www.fda.gov/emergency-preparedness-and-response/mcm-issues/smallpox-preparedness-and-response-updates-fda

Excerpt from News Release from Bavarian Nordic: “Since 2003, Bavarian Nordic has worked with the U.S. government on the development, manufacturing and supply of a non-replicating smallpox vaccine to ensure all populations can be protected from smallpox, including people with weakened immune systems who are at high risk of adverse reactions to traditional smallpox vaccines, which are based on replicating vaccinia virus strains. To date, the Company has supplied nearly 30 million doses of the liquid-frozen version to HHS, with the vast majority being delivered for emergency use before approval of the vaccine by the FDA in 2019. Since 2009, BARDA has supported the development of a freeze-dried version of the vaccine with longer shelf-life to replace the stockpile and in 2017 awarded the Company a ten-year contract valued at USD 539 million for supply of freeze-dried vaccines. Part of this contract (USD 37 million) has funded the Phase 3 study. Also, under this contract Bavarian Nordic has produced bulk vaccine worth of USD 253 million which will add to the existing stock of bulk manufactured under previous orders, collectively resulting in approximately 13 million doses for future delivery. The majority of the contract (USD 299 million), however, will be realized upon supply of the freeze-dried doses, which will be manufactured at the Company’s the new fill-finish facility”. https://web.archive.org/web/20220518053540/https://www.bavarian-nordic.com/investor/news/news.aspx?news=6569

This post is for informational/educational purposes only. To see if you are still immune, according to the criteria laid out in the paper, you would need to have appropriate blood work done. Do your own research and consult with a trusted medical professional. The cases in the above paper,from 2008, appear to have been with the original vaccine, and possibly second generation vaccine, so may or may not be applicable to the newer vaccine type.