Smallpox Vaccination and Adverse Cardiac Events

摘要

To the Editor: The incidence ofadverse cardiac events related tosmallpox vaccinations administeredduring the National SmallpoxVaccination Program (NSVP) in 2003has received widespread attention.From January 24 through August 8,2003, suspected or probable myo- orpericarditis was reported in 22 of38,257 civilian vaccinees (1); as ofNovember 4, 2003, suspected or prob-able myo- or pericarditis was reportedin 63 of 515,000 military vaccinees(2). Additionally, cases of coronaryartery disease, including myocardialinfarction and cardiac death, werereported in the weeks after vaccina-tion although no causal link has beenestablished. An October 3, 2003, MMWR arti-cle, "Cardiac deaths after a masssmallpox vaccination campaign—New York City, 1947" states that theNYC experience suggests "…that car-diac deaths observed in 2003 mighthave been unrelated to smallpox vac-cination." While the causes of thesecardiac or coronary deaths have notbeen established, the 1947 data lackthe power to address whether there isa relationship to the vaccine