[Immunopathological circumstances in the structure of complications appearing after smallpox vaccination]. / Circumstante imunopatologice în structura accidentelor survenite dupa vaccinarea antivariolica

Investigations were carried out concerning the dynamics of antivaccinal antibodies and the structure of serum proteins in relation to the clinical manifestations following upon smallpox vaccination. In general, immunity is not apparently influenced by postvaccinal complications may be associated with immunoprotein perturbations, manifested by an increase in the alpha2-globulin fraction and, inconstantly, in the gamma-globulin fraction. Immunoelectrophoretic determinations revealed a relatively constant IgM and IgG deficiency. Postvaccinal dysglobulinemia may accompany various clinical forms, suggesting a temporary deficient immunological response. In one case of agammaglobulinemia, revaccination produced a deep vaccinal ulcer, with extensive necrosis (giant necrotic vaccinia). In order to decipher the substrate of the reaction in the clinical forms with distal manifestations or generalized vaccinia, skin biopsies were performed. The lesional vasculoallergic substrate of the skin lesions does not exclude the local aggression of the vaccinal virus, which was isolated by viral determinations.

Investigations on allergic and serological reactions following inoculation of inactivated smallpox vaccines by cutaneous scarification.

A number of 154 young adults were given a smallpox vaccine inactivated by UV (103 subjects) or by 4degrees/00 formol (51 subjects). Inoculation induced an early cutaneous reaction in 75.4% of the revaccinated subjects. The incidence of positive HAI reactions in this group increased from 30.2% before vaccination to 63.8% after inoculation, while the geometric mean titer increased from 2.88 to 10.73. This would prove the early reactions to be allergic responses of organisms sensitized against smallpox vaccine, capable of stimulating antibody formation. No cutaneous reaction was recorded in the 7 persons vaccinated for the first time (without pre-existent cutaneous scars). These subjects developed neither cutaneous nor humoral response to the killed virus, as there was no previous sensitization to the respective antigen.

Comparative study of cutaneous scars and HAI antibodies after smallpox revaccination.

The number and aspect of cutaneous scars and the HAI antibody titer were recorded in 154 20-21-year-old subjects before smallpox revaccination, 30 and 300 days afterwards. In 38.3% of the vaccinees there were no postvaccinal scars 300 days after revaccination, but the absence of residual scars did not necessarily indicate a failure of immunization, since the increase in mean HAI antibody titer was significant in most of the cases.