Interim Guidelines for Smallpox Response and Management in Scotland in the Post-Eradication era

Distribution

Vaccine will be required by RSDRTs and Smallpox Vaccination Centres. RSDRTs will have already been allocated a supply of smallpox vaccine from the SEHD at Alert Level 0. If this amount is insufficient or where vaccine is required at Smallpox Vaccination Centres the SEHD should be notified with specific details of requirements including the following:

The number of doses required.
Where the vaccine is to be sent.
Name, location and phone number of person to be sent vaccine.
When the vaccine is required.
The security arrangements at the vaccination site.
Whether storage facilities at 2-8 ^oC for vaccine are available at the site.
Whether the vaccination equipment described in Appendix 12 (items such as gloves, sharps containers, dressings etc) is available in sufficient quantities.
Whether there photocopying facilities, faxes, computer printers and email facilities are available to produce copies of paperwork.
Whether any other items are required for vaccination to proceed.

The SEHD will approve the release of stocks and notify the holder of vaccine to release stocks. They will also arrange for transport of the vaccine to the vaccination site and notify the RSDRT or Smallpox Vaccination Centre of the expected time of arrival.
The vaccine holder will confirm details by fax with the SEHD and pack the vaccine ready for transport at 2-8 ^oC.
Vaccine must be transported under secure conditions, and the assistance of local police forces may be required to ensure this.
Smallpox packs in which the smallpox vaccine will be distributed will contain:

Smallpox vaccine.
Diluent for vaccine.
Bifurcated needles.
Product Information Leaflet (PIL) and Specification Product Certificate (SPC) either as separate forms or on the one form.
At least 100 hard copies of Forms i to x (see Appendices 16 and 17) and a floppy disc, which may be copied further or printed at the vaccination site.
The latest version of the 'Interim Guidelines for Smallpox Response and Management in the Post-Eradication Era'.
A vaccination training video, if the vaccinators are inexperienced in smallpox vaccination techniques.

Depending on whether vaccination equipment is available at the site, and following discussions with the SEHD, the smallpox packs may also contain some of the items listed in Appendix 12.

Storage

Vaccine should be kept refrigerated or on ice at 2-8 ^oC when not in use.
It is suggested that RDSRGs develop systems for storing and sharing supplies of vaccine locally should an emergency arise.
Unopened packs of vaccine should not be opened unless it is to be used. SEHD should be notified of unused packages of vaccine and they may then arrange for recall or redistribution to other vaccination sites.

Dilution

An American human volunteer study (published in 2002) suggests that a 1 in 10 dilution of smallpox vaccine may still give protection. It is envisaged that the UK smallpox vaccine will not need to be diluted.

The Scottish Government