Logan Reed
The smallpox vaccine is known for leaving a scar on the upper arm of the recipient. The scar is usually round or oval-shaped, about the size of a dime, and may appear deeper than the surrounding skin. The smallpox vaccine contains a live virus, which creates a controlled infection in the body, forcing the immune system to defend itself against the virus. This process leads to an itchy, painful, and red skin lesion that eventually forms a scab and leaves a permanent scar as it dries up. While the smallpox vaccine is no longer commonly administered, the scar it leaves behind is a distinctive mark of its historical use.
| Characteristics | Values |
|---|---|
| Name of the vaccine | Smallpox vaccine |
| Other names | Dryvax, ACAM2000, JYNNEOS |
| Virus type | Live virus |
| Virus name | Vaccinia |
| Virus similarity | Similar to smallpox but not as dangerous |
| Symptoms | Itchy, painful, and red skin lesion |
| Time taken for symptoms to appear | 3 to 4 days |
| Time taken for scar formation | 6 to 8 days |
| Scar shape | Round or oval |
| Scar size | About the size of a dime |
| Scar depth | Deeper or lower than the surrounding skin |
| Scar texture | Irregular edges |
| Scar location | Upper arm |
| Age group | People over 40 years of age |
| Other possible complications | Aggressive skin tumors, eczema vaccinatum |
| Treatment | Sunscreen, moisturizer, scar cream, skin camouflage creams and powders |
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What You'll Learn
The smallpox vaccine
Smallpox was a highly contagious disease caused by the variola virus. It was considered one of the deadliest infectious diseases, killing about 30% of those infected. The symptoms of smallpox were gruesome: high fever, vomiting, mouth sores, followed by fluid-filled lesions on the whole body. Death would come suddenly, often within 2 weeks, and survivors could be left with permanent harm such as blindness and infertility.
Today, the smallpox vaccine is no longer routinely administered to the general public. However, it is still being produced for research and to guard against bioterrorism, biological warfare, and mpox.
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How the smallpox vaccine causes scarring
The smallpox vaccine, which uses a live virus called vaccinia, creates a controlled infection in the body, forcing the immune system to defend itself against smallpox. This controlled infection causes an injury at the injection site, resulting in a sore and itchy bump that later blisters and becomes a permanent scar as it dries up.
The smallpox vaccine was typically administered using a bifurcated needle with a two-pronged or multiple puncture technique. This method caused a skin reaction during the healing process, leading to the formation of a scar. The scar is usually round or oval-shaped, about the size of a dime, and may appear deeper or lower than the surrounding skin.
The appearance of the scar can vary, with some people experiencing an inflammatory response resulting in a larger, raised scar. The scar is generally considered a sign that the vaccine was successful in stimulating an immune response. However, the absence of a scar does not necessarily indicate that the vaccine was ineffective, as other factors can influence scar formation.
The specific type of smallpox vaccine received can also affect the likelihood and appearance of scarring. For example, the Dryvax vaccine, which is no longer in use, was known to frequently cause smallpox vaccine scars. In contrast, the JYNNEOS vaccine, which is currently preferred for mpox prevention, does not typically lead to skin lesions or scarring.
While smallpox vaccination scars are less common today due to the eradication of the disease and reduced vaccination needs, they remain a distinctive mark for those who received the vaccine in the past. These scars are typically found on the upper arm and can be long-lasting, with some individuals considering treatments to reduce their appearance.
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The BCG vaccine scar
The bacillus Calmette-Guerin (BCG) vaccine is a vaccine for tuberculosis (TB) that is administered at birth in many countries outside the US. The BCG vaccine leaves a scar, which is often used as proof of prior immunization. The scar is typically raised in the middle and has rounded edges. It is caused by an immune reaction in the skin.
The BCG vaccine was first used medically in 1921 and is on the World Health Organization's List of Essential Medicines. As of 2004, about 100 million children globally receive the vaccine each year. The vaccine is injected into the skin, and common side effects include redness, swelling, and mild pain at the injection site.
The BCG vaccine is contraindicated for individuals with a reactive tuberculin skin test due to the risk of severe local inflammation and scarring. It is also contraindicated for those with IL-12 receptor pathway defects. In rare cases, the vaccine can cause a local abscess that may require treatment with antibiotics to prevent severe damage to vital organs.
Studies have found that having a BCG scar is associated with a lower prevalence of self-reported chronic, respiratory, and allergic diseases. This suggests that the BCG vaccine has beneficial non-specific effects beyond its intended purpose of preventing tuberculosis.
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Treatments for smallpox vaccination scars
The smallpox vaccine, ACAM2000, is a live vaccine that contains a live version of vaccinia, a virus similar to smallpox but not as dangerous. The vaccine is administered using a bifurcated (two-pronged) needle to cause a small, controlled infection in the skin. This creates a minor infection that forces the body's immune system to defend itself against the virus.
The smallpox vaccine leaves a permanent scar on the upper arm in some people. This is due to the body's natural healing process, where scar tissue grows more quickly than normal skin cells. The scar is typically round or oval-shaped and about the size of a dime, although some people may have larger scars. It is usually lower than the skin around it and may have irregular edges.
If you are interested in reducing the appearance of your smallpox vaccination scar, you can talk to a dermatologist about possible treatments. Here are some options to consider:
- Using sunscreen and moisturizer on the scar can help protect the area, which may be more sensitive than the surrounding skin.
- Your dermatologist may recommend a scar cream to help the scar heal and make it less noticeable.
- There are also "skin camouflage" creams and powders available that can be applied to cover and conceal the scar.
- In some cases, people may choose to undergo scar revision procedures to reduce the appearance of the scar.
It is important to note that smallpox scars are typically removed or revised for cosmetic reasons rather than health concerns. Additionally, the smallpox vaccine is no longer routinely administered, and most people who have the smallpox vaccine scar are over 40 years old.
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The JYNNEOS vaccine
The vaccine is safe and effective, with no new or unexpected safety concerns identified. The most common adverse reactions are injection site symptoms such as redness, swelling, pain, and itching. Myocarditis and pericarditis are adverse events of special interest, but the observed rates are consistent with expected background rates.
Unlike the previous smallpox vaccine, ACAM2000, which could leave a scar at the injection site, the JYNNEOS vaccine does not cause skin lesions or scarring. Common side effects include temporary itching, pain, or redness at the injection site.
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Frequently asked questions
The smallpox vaccine is known to leave a scar. The scar is usually found on the upper arm and is about the size of a dime.
The smallpox vaccine contains a live virus, which creates a controlled infection in your skin. This minor infection causes an immune reaction in your skin, leading to a small scar.
The smallpox vaccine scar is typically round or oval-shaped and may have irregular edges. It appears “deeper" or lower than the surrounding skin.
Routine smallpox vaccination ended in the United States in 1972. As a result, only people over 40 or 42 years old are likely to have a smallpox vaccination scar.
While the scar is permanent, you can reduce its appearance. Talk to a dermatologist about treatments, which may include using sunscreen, moisturizer, or scar cream.
