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. 2001 Nov-Dec;7(6):920–926. doi: 10.3201/eid0706.010602

Developing new smallpox vaccines.

S R Rosenthal 1, M Merchlinsky 1, C Kleppinger 1, K L Goldenthal 1
PMCID: PMC2631916  PMID: 11747717

Abstract

New stockpiles of smallpox vaccine are required as a contingency for protecting civilian and military personnel against deliberate dissemination of smallpox virus by terrorists or unfriendly governments. The smallpox vaccine in the current stockpile consists of a live animal poxvirus (Vaccinia virus [VACV]) that was grown on the skin of calves. Because of potential issues with controlling this earlier manufacturing process, which included scraping VACV lesions from calfskin, new vaccines are being developed and manufactured by using viral propagation on well-characterized cell substrates. We describe, from a regulatory perspective, the various strains of VACV, the adverse events associated with calf lymph-propagated smallpox vaccine, the issues regarding selection and use of cell substrates for vaccine production, and the issues involved in demonstrating evidence of safety and efficacy.

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Selected References

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  1. Adels B. R., Oppé T. E. Treatment of eczema vaccinatum with N-methylisatin beta-thiosemicarbazone. Lancet. 1966 Jan 1;1(7427):18–20. doi: 10.1016/s0140-6736(66)90006-7. [DOI] [PubMed] [Google Scholar]
  2. Bray M., Martinez M., Smee D. F., Kefauver D., Thompson E., Huggins J. W. Cidofovir protects mice against lethal aerosol or intranasal cowpox virus challenge. J Infect Dis. 2000 Jan;181(1):10–19. doi: 10.1086/315190. [DOI] [PubMed] [Google Scholar]
  3. Breman J. G., Henderson D. A. Poxvirus dilemmas--monkeypox, smallpox, and biologic terrorism. N Engl J Med. 1998 Aug 20;339(8):556–559. doi: 10.1056/NEJM199808203390811. [DOI] [PubMed] [Google Scholar]
  4. CANGEMI V. F. Acute pericarditis after smallpox vaccination. N Engl J Med. 1958 Jun 19;258(25):1257–1259. doi: 10.1056/NEJM195806192582507. [DOI] [PubMed] [Google Scholar]
  5. COCKBURN W. C., CROSS R. M., DOWNIE A. W., DUMBELL K. R., KAPLAN C., MCCLEAN D., PAYNE A. M. Laboratory and vaccination studies with dried smallpox vaccines. Bull World Health Organ. 1957;16(1):63–77. [PMC free article] [PubMed] [Google Scholar]
  6. CONYBEARE E. T. ILLNESS ATTRIBUTED TO SMALLPOX VACCINATION DURING 1951-60. Mon Bull Minist Health Public Health Lab Serv. 1964 Aug;23:126–CONTD. [PubMed] [Google Scholar]
  7. COPEMAN P. W., WALLACE H. J. ECZEMA VACCINATUM. Br Med J. 1964 Oct 10;2(5414):906–908. doi: 10.1136/bmj.2.5414.906. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Centers for Disease Control (CDC) Contact spread of vaccinia from a National Guard vaccinee--Wisconsin. MMWR Morb Mortal Wkly Rep. 1985 Apr 5;34(13):182–183. [PubMed] [Google Scholar]
  9. Centers for Disease Control (CDC) Smallpox vaccine no longer available for civilians--United States. MMWR Morb Mortal Wkly Rep. 1983 Jul 29;32(29):387–387. [PubMed] [Google Scholar]
  10. Centers for Disease Control (CDC) Vaccinia outbreak--Nevada. MMWR Morb Mortal Wkly Rep. 1983 Aug 12;32(31):403–404. [PubMed] [Google Scholar]
  11. Centers for Disease Control (CDC) Vaccinia outbreak--Newfoundland. MMWR Morb Mortal Wkly Rep. 1981 Sep 18;30(36):453–455. [PubMed] [Google Scholar]
  12. ESPMARK J. A. SMALLPOX VACCINATION STUDIES WITH SERIAL DILUTIONS OF VACCINE. 1. PRIMARY VACCINATION AND REVACCINATION IN HUMAN ADULTS. Acta Pathol Microbiol Scand. 1965;63:97–115. doi: 10.1111/apm.1965.63.1.97. [DOI] [PubMed] [Google Scholar]
  13. Feery B. J. The efficacy of vaccinial immune globulin. A 15-year study. Vox Sang. 1976;31(1 Suppl):68–76. doi: 10.1111/j.1423-0410.1976.tb02224.x. [DOI] [PubMed] [Google Scholar]
  14. Fulginiti V. A., Winograd L. A., Jackson M., Ellis P. Therapy of experimental vaccinal keratitis. Effect of idoxuridine and VIG. Arch Ophthalmol. 1965 Oct;74(4):539–544. doi: 10.1001/archopht.1965.00970040541019. [DOI] [PubMed] [Google Scholar]
  15. GREENBERG M. Complications of vaccination against smallpox. Am J Dis Child. 1948 Nov;76(5):492–502. doi: 10.1001/archpedi.1948.02030030505002. [DOI] [PubMed] [Google Scholar]
  16. Goldstein J. A., Neff J. M., Lane J. M., Koplan J. P. Smallpox vaccination reactions, prophylaxis, and therapy of complications. Pediatrics. 1975 Mar;55(3):342–347. [PubMed] [Google Scholar]
  17. Henderson D. A. Smallpox: clinical and epidemiologic features. Emerg Infect Dis. 1999 Jul-Aug;5(4):537–539. doi: 10.3201/eid0504.990415. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Henderson D. A. The looming threat of bioterrorism. Science. 1999 Feb 26;283(5406):1279–1282. doi: 10.1126/science.283.5406.1279. [DOI] [PubMed] [Google Scholar]
  19. Holtzman C. M. Postvaccination arthritis. N Engl J Med. 1969 Jan 9;280(2):111–112. doi: 10.1056/nejm196901092800223. [DOI] [PubMed] [Google Scholar]
  20. KEMPE C. H., BERGE T. O., ENGLAND B. Hyperimmune vaccinal gamma globulin; source, evaluation, and use in prophylaxis and therapy. Pediatrics. 1956 Aug;18(2):177–188. [PubMed] [Google Scholar]
  21. KEMPE C. H., BOWLES C., MEIKLEJOHN G., BERGE T. O., ST VINCENT L., BABU B. V., GOVINDARAJAN S., RATNAKANNAN N. R., DOWNIE A. W., MURTHY V. R. The use of vaccinia hyperimmune gamma-globulin in the prophylaxis of smallpox. Bull World Health Organ. 1961;25:41–48. [PMC free article] [PubMed] [Google Scholar]
  22. Koplan J. P., Marton K. I. Smallpox vaccination revisited. Some observations on the biology of vaccinia. Am J Trop Med Hyg. 1975 Jul;24(4):656–663. [PubMed] [Google Scholar]
  23. Lane J. M., Millar J. D. Routine childhood vaccination against smallpox reconsidered. N Engl J Med. 1969 Nov 27;281(22):1220–1224. doi: 10.1056/NEJM196911272812205. [DOI] [PubMed] [Google Scholar]
  24. Lane J. M., Ruben F. L., Abrutyn E., Millar J. D. Deaths attributable to smallpox vaccination, 1959 to 1966, and 1968. JAMA. 1970 Apr 20;212(3):441–444. [PubMed] [Google Scholar]
  25. Lane J. M., Ruben F. L., Neff J. M., Millar J. D. Complications of smallpox vaccination, 1968. N Engl J Med. 1969 Nov 27;281(22):1201–1208. doi: 10.1056/NEJM196911272812201. [DOI] [PubMed] [Google Scholar]
  26. Lane J. M., Ruben F. L., Neff J. M., Millar J. D. Complications of smallpox vaccination, 1968: results of ten statewide surveys. J Infect Dis. 1970 Oct;122(4):303–309. doi: 10.1093/infdis/122.4.303. [DOI] [PubMed] [Google Scholar]
  27. Lublin-Tennenbaum T., Katzenelson E., el-Ad B., Katz E. Correlation between cutaneous reaction in vaccinees immunized against smallpox and antibody titer determined by plaque neutralization test and ELISA. Viral Immunol. 1990 Spring;3(1):19–25. doi: 10.1089/vim.1990.3.19. [DOI] [PubMed] [Google Scholar]
  28. Marmelzat W. L. Malignant tumors in smallpox vaccination scars: a report of 24 cases. Arch Dermatol. 1968 Apr;97(4):400–406. [PubMed] [Google Scholar]
  29. McClain D. J., Harrison S., Yeager C. L., Cruz J., Ennis F. A., Gibbs P., Wright M. S., Summers P. L., Arthur J. D., Graham J. A. Immunologic responses to vaccinia vaccines administered by different parenteral routes. J Infect Dis. 1997 Apr;175(4):756–763. doi: 10.1086/513968. [DOI] [PubMed] [Google Scholar]
  30. NANNING W. Prophylactic effect of antivaccinia gamma-globulin against post-vaccinal encephalitis. Bull World Health Organ. 1962;27:317–324. [PMC free article] [PubMed] [Google Scholar]
  31. Neff J. M., Drachman R. H. Complications of smallpox vaccination, 1968 surveillance in a Comprehensive Care Clinic. Pediatrics. 1972 Sep;50(3):481–483. [PubMed] [Google Scholar]
  32. Neff J. M., Lane J. M., Pert J. H., Moore R., Millar J. D., Henderson D. A. Complications of smallpox vaccination. I. National survey in the United States, 1963. N Engl J Med. 1967 Jan 19;276(3):125–132. doi: 10.1056/NEJM196701192760301. [DOI] [PubMed] [Google Scholar]
  33. Neff J. M., Levine R. H., Lane J. M., Ager E. A., Moore H., Rosenstein B. J., Millar J. D., Henderson D. A. Complications of smallpox vaccination United States 1963. II. Results obtained by four statewide surveys. Pediatrics. 1967 Jun;39(6):916–923. [PubMed] [Google Scholar]
  34. Redfield R. R., Wright D. C., James W. D., Jones T. S., Brown C., Burke D. S. Disseminated vaccinia in a military recruit with human immunodeficiency virus (HIV) disease. N Engl J Med. 1987 Mar 12;316(11):673–676. doi: 10.1056/NEJM198703123161106. [DOI] [PubMed] [Google Scholar]
  35. Sharp J. C., Fletcher W. B. Experience of anti-vaccinia immunoglobulin in the United Kingdom. Lancet. 1973 Mar 24;1(7804):656–659. doi: 10.1016/s0140-6736(73)92215-0. [DOI] [PubMed] [Google Scholar]
  36. Sugimoto M., Yamanouchi K. Characteristics of an attenuated vaccinia virus strain, LC16m0, and its recombinant virus vaccines. Vaccine. 1994 Jun;12(8):675–681. doi: 10.1016/0264-410x(94)90215-1. [DOI] [PubMed] [Google Scholar]
  37. Sutter G., Moss B. Novel vaccinia vector derived from the host range restricted and highly attenuated MVA strain of vaccinia virus. Dev Biol Stand. 1995;84:195–200. [PubMed] [Google Scholar]
  38. do Valle L. A., de Melo P. R., de Gomes L. F., Proença L. M. Methisazone in prevention of variola minor among contacts. Lancet. 1965 Nov 13;2(7420):976–978. doi: 10.1016/s0140-6736(65)92840-0. [DOI] [PubMed] [Google Scholar]

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