A plan being considered by President Bush to vaccinate the vast majority of Americans against smallpox to counter a bioterrorism attack would likely have to skip those with HIV because their impaired immune systems may not be able to fight off the weakened virus used in the vaccines, The Boston Globe reports. Fred Rosen, an immunologist, said giving the smallpox vaccine to HIV-positive Americans could cause death or serious illness. Worse yet, it's even possible that the weakened virus used in the vaccine can be spread from the small pockmark scar caused by the vaccine to unvaccinated HIV-positive people, giving them the disease simply through skin-to-skin exposure.
"There are about a million people with the AIDS virus...and I don't know what is going to happen to them if they get vaccinia virus [used in the smallpox vaccines]," Rosen said. "I think they are going to die or have severe complications."
It is estimated that there are about 900,000 people in the United States who are HIV-positive. Anthony Fauci, director of the National Institute on Allergy and Infectious Diseases, says that Rosen's concerns are valid, but he adds that the smallpox vaccine would be contraindicated for many people: "There will be very, very explicit recommendations for exclusion; for example, HIV-infected individuals, transplant recipients, people with immuno-suppressed conditions."