The Knox County Health Department has canceled plans for smallpox vaccinations due to the high number of needle insertions required. According to directions provided by the CDC, 15 insertions are required with a two-prong needle allowing for a total of 30 insertions.

After an extensive training session it has been discovered that employees of the Knox County Health Department simply lose count after an average of 8 insertions. Improper vaccinations could prove more harmful than the threat of smallpox.

As a public service to our readers we are including directions for self-treatment. Please note that smallpox vaccine will soon be at all Downtown Knoxville Pharmor locations.

Step 1 Skin Preparation: None
No skin preparation is required. Under no circumstances should alcohol be applied to the skin prior to vaccination as it has been shown to inactivate the vaccine virus.

Step 2 Dip Needle
The needle is dipped into the vaccine vial and withdrawn. The needle is designed to hold a minute drop of vaccine of sufficient size and strength to ensure a take if properly administered.

Step 3 Make 15 Perpendicular Insertions within a 5mm Diameter Area
The needle is held perpendicular to the site of insertion. The wrist of the vaccinator should be maintained in a firm position (*) by resting on the arm of the vaccinee or other firm support.

Fifteen perpendicular insertions are made in rapid order in an area approximately 5 mm in diameter. Strokes should be vigorous enough to evoke a trace of blood at the site after 15-30 seconds. The bifurcated needle is for single usage only and should be discarded in an appropriate biohazard container immediately after vaccinating each patient.
Caution: Needles should never be dipped into the vaccine vial more than once, in order to avoid contamination of the vial.

Step 4 Absorb Excess Vaccine
After vaccination, excess vaccine should be absorbed with sterile gauze. Discard the gauze in a safe manner (usually in a hazardous waste receptacle) in order not to contaminate the site or infect others who may come in contact with it.

Step 5 Cover Vaccination Site
It is important that the vaccination site be covered to prevent dissemination of virus.

Recommended covering:
• Sterile gauze loosely held down by tape (†)

Other coverings that have been used:
• Perforated plastic bubble
• Semipermeable membrane occlusive dressing

Step 6 Caution Vaccinee and/or Guardian
To avoid contact transmission of the virus, vaccinees and guardians must be cautioned:
• No rubbing or scratching of vaccination site
• Discard gauze carefully
• Wash hands thoroughly after handling gauze

Ingestion and intramuscular injection of a dose of vaccine are NOT recommended routes of administration. However, no harm has been recorded from such events.

* When vaccinating infants or children, it may be necessary to appropriately restrain the child to avoid accidents during administration.

† Some also advise pinning an additional piece of sterile gauze to clothing over the vaccination site.