Naturally occurring smallpox has been eradicated worldwide and smallpox vaccination is associated with the risk of significant morbidity and even mortality. The overall risk-benefit analysis supports the recommendation to not routinely immunize the general Canadian population against smallpox. As a result, smallpox vaccination is highly restricted.
BEFORE INITIATION OF IMMUNE SUPPRESSION
Not recommended in Canada.
WHAT TO DO IF ALREADY IMMUNOSUPPRESSED (ON ANTI-TNF OR IMMUNOMODULATOR)