Vaccinia Immune Globulin

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Vaccinia immune globulin (VIG) is made from the pooled blood of individuals who have been inoculated with the smallpox vaccine. The antibodies these individuals developed in response to the smallpox vaccine are removed and purified. This results in VIG. It can be administered intravenously. It is used to treat individuals who have developed progressive vaccinia after smallpox vaccination. It was also used along with cidofovirinfor the 2003 Midwest monkeypox outbreak as concomitant therapy to reduce the serious side effects of smallpox vaccine.[1][2][3]

Adverse effects of smallpox vaccine

For a small percentage of the population, the smallpox vaccine either doesn't "take" or it produces adverse events. These include postvaccinial central nervous system disease, progressive vaccinia, eczema vaccinatum, accidental implantations, “generalized vaccinia,” and the common erythematous and/or urticarial rashes. [4][5][6]

Development of immune globulin

In the late 1940s, Dr. Henry Kempe suggested that the solution to the complications of the smallpox vaccine was to provide antibodies in the form of gamma globulin. [7][8] Kempe noted that for some infants, the smallpox vaccine failed to "take." Kempe believed this failure might be due to the high levels of maternal antibodies to vaccinia in the infants' blood. It appeared to Kempe, that the presence of the antibodies blocked viral replication and therefore a transfusion of antibodies from people who were immune due to vaccination, would help those in whom vaccination had failed. [9]

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References

  1. "CDC Smallpox | Investigational Vaccinia Immune Globulin (VIG) Information". Bt.cdc.gov. Retrieved 2013-06-16.
  2. CDC. Recommendations for using smallpox vaccine in the pre-event vaccination program: Supplemental recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR 2003; 52 (RR07); 1-16.
  3. Dana A. Shea, Frank gottron, Holly Harvey. Monkeypox Technical Background and Outbreak Implications for Bioterrorism Preparedness. Congressional Research Service, Report for Congress.
  4. J.Michael Lane, MD, MPH,aJoel Goldstein, MD, FAAPaAdverse events occurring after smallpox vaccination. Seminars in Pediatric Infectious Diseases. Volume 14, Issue 3, July 2003, Pages 189–195
  5. Frelinger JA, Garba ML. Responses to smallpox vaccine. N Engl J Med. 2002;347:689–90. DOI PubMed
  6. Moller-Larsen A, Haahr S. Humoral and cell-mediated immune responses in humans before and after revaccination with vaccinia virus. Infect Immun. 1978;19:34–9.PubMed • Cohen J. Smallpox vaccinations: how much protection remains? Science. 2001;294:985. DOI PubMed
  7. "Vaccinia immune globulin definition - Medical Dictionary definitions of popular medical terms easily defined on MedTerms". Medterms.com. 2012-06-14. Retrieved 2013-06-16.
  8. "CDC Smallpox | Medical Management of Smallpox (Vaccinia) Vaccine Adverse Reactions (Info for Clinicians and Public Health Professionals)". Bt.cdc.gov. Retrieved 2013-06-16.
  9. Bray, M. Henry Kempe and the Birth of the Vaccinia Immune Globulin. Clinical Infectious Diseases. Volume 39. Issue 6. pp. 767-769.

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