Ring Vaccination

This strategy vaccinates the contacts of confirmed smallpox patients, and will be the first-line strategy in a smallpox emergency. It also vaccinates people who are in close contact with those contacts. This way, everyone who has been, or could have been, exposed to a patient with smallpox receives the vaccine. Ring vaccination requires thorough and rapid surveillance and epidemiologic case investigation. The Intensified Smallpox Eradication Program used this strategy with great success in its efforts to eradicate smallpox in the latter half of the 20^th century.

In addition to the operational and logistical considerations for vaccination, consider the following in your department’s plans for implementing this strategy:

• Decide how to offer the vaccination to identified contacts. For example, do you give contacts referrals to get the vaccination at a designated location? Or do you offer the vaccination at a time and place convenient for the contact?
• Determine how to follow up with the contacts who are vaccinated to evaluate the vaccination site for a “take” (and possibly revaccination, if the vaccinee does not have a visible “take”).
• Identify ways to ensure people vaccinated with Imvamune return for their second dose (for primary vaccinees).