Chloe Ramirez
Smallpox vaccination was a major medical achievement, but it left a distinctive mark or scar on the upper arm. The vaccine was delivered using a bifurcated (two-pronged) needle that was dipped into the vaccine solution and then used to prick the skin multiple times. This caused a skin lesion, which scabbed over and formed a permanent scar within a few weeks. While smallpox was eradicated in 1979, the last smallpox vaccine was administered in the US in 1972, meaning that only people over 40 are likely to have the smallpox vaccine scar. Another vaccine that causes a similar scar is the Bacillus Calmette-Guérin (BCG) vaccine, which is used to protect against tuberculosis (TB). The BCG vaccine is not routinely given in the US, but it is often administered to infants and children in countries where TB is more prevalent.
| Characteristics | Values |
|---|---|
| Vaccine Name | Smallpox vaccine, ACAM2000, Dryvax, JYNNEOS, Bacille Calmette-Guérin (BCG) vaccine |
| Age Group | People over 40 years of age |
| Shape | Round or oval-shaped |
| Size | About the size of a dime |
| Location | Upper left arm |
| Appearance | Deeper or lower than the surrounding skin |
| Texture | Itchy or uncomfortable |
| Treatment | Sunscreen, moisturizer, scar cream, skin camouflage creams and powders |
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What You'll Learn
Smallpox vaccine scars are rare today
Smallpox vaccine scars are uncommon today, with only people over 40 years of age likely to have the dime-sized dent on their upper left arm. This is because the smallpox vaccine was discontinued in most circumstances in the United States in the 1970s, with routine smallpox vaccination ending in 1972. The last case of smallpox was reported in 1977. As a result of this discontinuation, the scar is now far less common than it used to be.
The smallpox vaccine was administered using a bifurcated needle and a multiple puncture technique. This caused a skin lesion, which typically turned into a pus-filled blister and scabbed within a few weeks. For most people, this resulted in a permanent depressed scar. The scar is generally round but may have irregular edges and appear deeper than the surrounding skin. It is usually smaller than the diameter of a pencil eraser, but it can be larger.
The vaccination causes an injury at the injection site, which leads to the scarring. The body's immune system reacts to the live virus in the vaccination by creating a defence that pushes the virus out. This reaction causes a scab to form, which may ooze and feel itchy and tight. As the scab falls off, it leaves behind an area of skin that looks like a pockmark.
The smallpox vaccine is no longer needed as smallpox has been eradicated globally. However, the vaccine can give some protection against mpox (formerly known as monkeypox). The smallpox vaccine can also cause a similar scar to the Bacille Calmette-Guérin (BCG) vaccine against tuberculosis.
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The scar is a sign the vaccine worked
The smallpox vaccine is known to leave a scar on the upper arm, which is a sign that the vaccine worked. The scar is usually round or oval-shaped, about the size of a dime, and may appear deeper than the surrounding skin. It is a result of the unique method of administering the vaccine, known as the multiple puncture technique. This technique involves using a bifurcated needle with two prongs to deliver the vaccine to the proper depth into the skin. The needle is dipped into the vaccine solution and then used to prick the skin multiple times in a small circle, causing a skin lesion that turns into a pus-filled blister and scab within a few weeks. As the scab falls off, it leaves behind a permanent scar.
The scar is a sign that the vaccine successfully spurred an immune response in the body to protect against smallpox. The vaccine contains a live virus, which creates a controlled infection that forces the immune system to defend the body against it. This process leads to the formation of a sore and itchy bump that later becomes a larger blister. The blister dries up and leaves behind a scar as it heals. The presence of the scar indicates that the vaccine was successful in creating an immune response.
The smallpox vaccine is no longer commonly administered, and most people with the vaccine scar are over 40 years old. The vaccine was discontinued in the United States in the 1970s, and smallpox was eradicated globally in 1980. Today, the vaccine is only given to certain groups, such as military service members and laboratory workers.
It is important to note that not all arm scars are from smallpox vaccines. The Bacille Calmette-Guérin (BCG) vaccine, which is commonly administered for tuberculosis (TB) outside of the United States, can also leave a similar-looking scar. This scar tends to have a raised center with rounded edges, while the smallpox vaccine scar is typically depressed with radiating lines.
While the smallpox vaccine scar is a sign of a successful immune response, it is not a guarantee of ongoing immunity. Immunity from the vaccine typically lasts for about 3 to 5 years, and revaccination may be recommended after this period to maintain protection.
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The Bacille Calmette-Guérin (BCG) vaccine also leaves a mark
The Bacille Calmette-Guérin (BCG) vaccine is primarily used to prevent tuberculosis (TB) disease. It is not routinely administered in the United States due to the low risk of contracting TB bacteria in the country, the variable effectiveness of the vaccine against adult pulmonary TB, and its potential to cause false-positive TB skin test results. However, it is often given to infants and children in countries where TB is more prevalent, such as Iran, South Africa, Morocco, and Kenya.
The BCG vaccine can leave a distinctive scar on the arm, similar in appearance to the smallpox vaccine scar. This scar is typically round or oval-shaped and about the size of a dime, although it may vary in depth compared to the surrounding skin. The BCG scar is a result of the vaccination process, which involves a controlled infection that stimulates the body's immune response. This response leads to the formation of a blister, which eventually dries up and leaves a permanent scar.
The BCG vaccine is given as a single intradermal injection, usually in the right arm. While it is generally safe, one potential complication is the formation of a local abscess or "BCG-oma". This complication may require immediate treatment with antibiotics to prevent the infection from spreading and causing severe damage to vital organs. The BCG-oma is not always an indication of incorrect vaccine administration and can occur even with proper injection techniques.
The presence of a BCG immunization scar is often used as proof of prior immunization, especially in countries where TB is endemic. The BCG vaccine has also been studied for its potential benefits beyond TB prevention, including possible protection against COVID-19 and other respiratory infections. However, the evidence for its effectiveness against COVID-19 is inconclusive, and the World Health Organization (WHO) does not recommend BCG vaccination for the prevention of COVID-19 at this time.
In summary, the Bacille Calmette-Guérin (BCG) vaccine is a crucial tool in the fight against tuberculosis, particularly in high-incidence regions. The vaccine's characteristic scar is a result of the body's immune response to the controlled infection induced by the vaccine. While generally safe, the BCG vaccine can occasionally cause complications such as local abscesses, and its effectiveness may vary depending on regional TB prevalence and individual factors.
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The smallpox vaccine is no longer routine
Smallpox was a highly contagious and deadly disease, with a historical mortality rate of about 30%. The development of the smallpox vaccine was a groundbreaking achievement in the history of medicine. The vaccine was first introduced in the late 1700s, and it played a crucial role in the global eradication of smallpox. The success of the smallpox vaccine led to its routine administration for many decades. However, due to the successful worldwide immunization efforts, the disease is no longer a public health threat.
Routine smallpox vaccination among the American public stopped in 1972 after the disease was eradicated in the United States. Similarly, in 1980, the World Health Organization (WHO) maintained a stockpile of 200 million doses of the vaccine, but 99% of it was destroyed in the late 1980s when smallpox failed to re-emerge. While the vaccine is no longer routine, it is still being produced for research purposes and to guard against potential bioterrorism and biological warfare.
The smallpox vaccine was known to leave a distinctive scar on the upper arm during the healing process. This scar was typically round or oval-shaped and about the size of a dime. It was a sign that the vaccine had successfully spurred an immune response in the body. However, with the decrease in smallpox vaccination rates, these scars are also becoming less common. Today, smallpox vaccine scars are primarily found in individuals over 40 who received the vaccine during widespread vaccination campaigns.
While the smallpox vaccine is no longer routine, it is important to note that it still has a role in certain specific situations. The vaccine is currently recommended for certain groups, such as military service members and laboratory workers. Additionally, in the event of a smallpox outbreak, health officials would use the vaccine to control the spread of the disease. Furthermore, the smallpox vaccine can provide some cross-protection against mpox (formerly known as monkeypox), offering about 85% effectiveness in preventing the disease.
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The scar is usually round or oval-shaped
The smallpox vaccine, which is no longer routinely administered, often left a round or oval-shaped scar on the upper arm. The scar is usually about the size of a dime, although it can be larger. It may also appear deeper or lower than the surrounding skin.
The smallpox vaccine was administered using a bifurcated needle with a two-pronged or multiple puncture technique. This caused a skin lesion, typically turning into a pus-filled blister and scabbing within a few weeks. As the body repairs the damage, it forms scar tissue. For most people, this scar tissue is small and round or oval-shaped. However, some people experience an inflammatory response to the injection, which can lead to a larger, raised scar.
The scar from the smallpox vaccine is a sign that the vaccine was successful in creating an immune response in the body. The vaccine contains a live virus, which creates a controlled infection that the body must fight off. This process leaves behind a small mark on the skin where the infection and related inflammation took place.
It's important to note that not everyone who received the smallpox vaccine will have a scar. Additionally, the Bacille Calmette-Guérin (BCG) vaccine against tuberculosis can also leave a similar-looking scar on the arm. This scar tends to have a raised center with rounded edges, while the smallpox vaccine scar is typically depressed with lines radiating outward.
Today, the smallpox vaccine is only given to certain groups, such as military service members and laboratory workers. The ACAM2000 and JYNNEOS vaccines are currently licensed in the US for smallpox prevention, but they are not associated with scar formation.
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Frequently asked questions
Vaccines can cause a localised infection at the injection site, which your body then fights off, leaving behind a small mark where the infection took place.
A smallpox vaccine scar typically appears round or oval-shaped, about the size of a dime, and may look deeper or lower than the surrounding skin.
Yes, the Bacille Calmette-Guérin (BCG) vaccine, which is given to prevent tuberculosis, can also leave a scar that resembles a smallpox vaccine scar.
Smallpox vaccine scars are not very common nowadays as routine smallpox vaccination ended in the early 1970s. Only people over 40 years of age are likely to have received the smallpox vaccine and have the resulting scar.
While smallpox vaccine scars are usually permanent, you can use sunscreen and moisturiser to protect the area, and your dermatologist may recommend a scar cream to help it heal and become less noticeable.
