Introduction
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IMPORTANT WARNING:
Smallpox and mpox (vaccinia) vaccine, live may cause damage to the heart. Tell whoever will be giving the vaccine if you have or have ever had a heart attack, heart failure, a stroke or transient ischemic attack (TIA; mini stroke), or other heart problems. If you experience any of the following symptoms, call your doctor immediately: chest pain, shortness of breath, difficulty breathing, or changes in heartbeat.
Smallpox and mpox (vaccinia) vaccine, live may cause damage to the brain or spinal cord. If you experience any of the following symptoms, call your doctor immediately: stiff neck, confusion, agitation, trouble moving body parts, muscle weakness, loss of consciousness, or seizures.
Smallpox and mpox (vaccinia) vaccine, live may cause skin disorders. Tell whoever will be giving the vaccine if you have or have ever had eczema or other skin conditions. If you experience any of the following symptoms, call your doctor immediately: rash, particularly around the site of injection, a sore that will not heal.
Smallpox and mpox (vaccinia) vaccine, live may cause damage to the eye(s) that may lead to blindness if the vaccine is accidentally spread to the eye. If you experience any of the following symptoms, call your doctor immediately: watery, painful eyes, blurred vision, or changes in vision.
Smallpox and mpox (vaccinia) vaccine, live may be passed along to other people that you have close contact with you for up to 6 weeks after vaccination. Avoid close contact (skin or objects that touch the skin) with those who are immunocompromised, have or have ever had eczema. Also avoid contact with those who are pregnant or infants who are less than 12 months of age.
You should not receive Smallpox and mpox (vaccinia) vaccine, live if you are pregnant or plan to become pregnant. You or your partner should not become pregnant for 6 weeks after vaccination or until the site of vaccination has healed.
Talk to your doctor about the risk(s) of receiving smallpox vaccine, live.
Why get vaccinated?
Smallpox and mpox (vaccinia) vaccine, live may prevent smallpox or mpox that may occur with infection due to orthopoxviruses.
Infection with these viruses can cause the following: skin rashes and lesions, fever, muscle aches, swollen lymph nodes that may be life-threatening.
Smallpox and mpox (vaccinia) vaccine, live contains a live virus that has been weakened so it does not cause disease but can still stimulate the body to make antibodies against the virus to provide a defense against potential infection.
How is the vaccine given?
Smallpox and mpox (vaccinia) vaccine, live comes as a suspension (liquid) to be given by a puncture device into the skin of your upper arm by a healthcare provider. Keep the injection site on your arm bandaged until the vaccination site is fully healed. Follow all directions for changing this bandage and caring for the site of injection to prevent spread of the virus.
Smallpox vaccine, live is given as a single dose. It may be given again at a later time as recommended by your doctor.
What should you tell the person who is giving the vaccine?
Tell your vaccine provider if you:
In some cases, your health care provider may decide to postpone vaccination to a future visit.
What are the risks from vaccination?
Side effects that have been reported with smallpox vaccine, live include:
Some side effects can be serious. If you experience any of these symptoms or those in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment:
People sometimes faint after medical procedures, including vaccination. Tell your provider if you feel dizzy or have vision changes or ringing in the ears.
Adverse reactions should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your health care provider will usually file this report, or you can do it yourself. Visit http://vaers.hhs.gov or call 1-800-822-7967. VAERS is only for reporting reactions, and VAERS staff members do not give medical advice.
How can I learn more?
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS® Patient Medication Information™ Copyright, 2026. The American Society of Health-System Pharmacists®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.
Selected Revisions: July 15, 2026.