Vaccinia immune globulin
|Drug class||Immune globulin|
|Main uses||Complications of smallpox vaccination, monkeypox|
|Side effects||Headache, dizziness, nausea|
|Typical dose||6000 units/kg|
Vaccinia immune globulin (VIG) is a medication used to treat severe complications of smallpox vaccination and monkeypox. With respect to complications, it is used for eczema vaccinatum, progressive vaccinia, severe generalized vaccinia, and vaccinia infections in those with certain skin conditions. It is given by gradual injection into a vein.
Common side effects include headache, dizziness, and nausea. Severe side effects may include allergic reactions, kidney problems, blood clotting, and transfusion-related acute lung injury. It is an immune globulin, specifically a gamma globulin, made from the blood of people immunized against smallpox.
Vaccinia immune globulin was approved for medical use in the United States in 2005. In the United States it is not commercially available though may be acquired from the Strategic National Stockpile. In Canada it is available from Public Health Agency of Canada.
Side effects from smallpox vaccine
For a small percentage of the population, the smallpox vaccine produces severe side effects. These include postvaccinial central nervous system disease, progressive vaccinia, eczema vaccinatum, accidental implantations, “generalized vaccinia,” and the common erythematous and/or urticarial rashes.
It may be used for:
- Eczema vaccinatum
- Progressive vaccinia
- Severe generalized vaccinia
- Vaccinia infections in individuals who have skin conditions such as burns, impetigo, or eczema
- Infections induced by vaccinia virus that include its accidental implantation in eyes (except in cases of isolated keratitis), mouth, or other areas where vaccinia infection would constitute a special hazard.
It is not effective for smallpox itself or for encephalitis post vaccination.
There; however, is no data on if it is effective.
It is generally given at a dose of 6000 units/kg.
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.  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. 
Society and culture
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.
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