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Table 3 Risk of vaccinia necrosum (V.N.) (progressive vaccinia) and death from primary smallpox vaccinations, Stratified by age and study, 1963–1968

From: Risks of serious complications and death from smallpox vaccination: A systematic review of the United States experience, 1963–1968

Age group and studies Number vaccinated V.N. No. Deaths No. Risk of complication per million (95% C.I.)a Risk of death per million (95% C.I.)a Case fatality risk per hundred (95% C.I.)a
Age <1          
   Neff 1967a 654,000 1 0 1.5 (0.04, 8.5) 0.0 (0.0, 5.6) 0.0 (0.0, 97.5)
   Neff 1967b 31,000 0 0 0.0 (0.0, 122) 0.0 (0.0, 119.0) n/a n/a
   Lane 1969 614,000 0 0 0.0 (0.0, 6.0) 0.0 (0.0, 6.0) n/a n/a
   Lane 1970 17,000 0 0 0.0 (0.0, 217) 0.0 (0.0, 217) n/a n/a
   Ratner 1970 1 0 0 n/c n/c n/c n/c n/a n/a
   Neff 1972 32 0 0 n/c n/c n/c n/c n/a n/a
   Summary 1,316,033 1 0 0.8 (0.02, 4.2) 0.0 (0.0, 2.8) 0.0 (0.0, 97.5)
Age 1 to 4          
   Neff 1967a 2,973,000 1 0 0.3 (0.01, 1.9) 0.0 (0.0, 1.2) 0.0 (0.0, 97.5)
   Neff 1967b 142,000 0 0 0.0 (0.0, 26.0) 0.0 (0.0, 26.0) n/a n/a
   Lane 1969 2,733,000 1 0 0.4 (0.01, 2.0) 0.0 (0.0, 1.3) 0.0 (0.0, 97.5)
   Lane 1970 317,000 1 0 3.2 (0.08, 17.6) 0.0 (0.0, 11.6) 0.0 (0.0, 97.5)
   Ratner 1970 68,002 0 0 0.0 (0.0, 54.2) 0.0 (0.0, 54.2) n/a n/a
   Neff 1972 517 0 0 0.0 (0.0, 7110) 0.0 (0.0, 7110) n/a n/a
   Summary 6,233,519 3 0 0.5 (0.1, 1.4) 0.0 (0.0, 0.6) 0.0 (0.0, 70.8)
Age 5 to 19          
   Neff 1967a 2,295,000 3 0 1.3 (0.3, 3.8) 0.0 (0.0, 1.6) 0.0 (0.0, 70.6)
   Neff 1967b 110,000 0 0 0 (0.0, 33.5) 0.0 (0.0, 33.5) n/a n/a
   Lane 1969 1,959,000 2 2 1.0 (0.1, 3.7) 1.0 (0.1, 3.7) 100 (15.8, 100)
   Lane 1970 229,000 0 0 0 (0.0, 16.1) 0.0 (0.0, 16.1) n/a n/a
   Ratner 1970b 193,721 0 0 0 (0.0, 19.0) 0.0 (0.0, 19.0) n/a n/a
   Summary 4,786,721 5 2 1.0 (0.34, 2.44) 0.4 (0.05, 1.5) 40.0 (5.3, 85.3)
Age 20 +          
   Neff 1967a 317,000 2 0 6.3 (0.8, 22.8) 0.0 (0.0, 11.6) 0.0 (0.0, 84.2)
   Neff 1967b 15,000 0 0 0.0 (0.0, 246) 0.0 (0.0, 246) n/a n/a
   Lane 1969 288,000 2 0 6.9 (0.8, 25.1) 0.0 (0.0, 12.8) 0.0 (0.0, 84.2)
   Lane 1970 33,000 0 0 0.0 (0.0, 112) 0.0 (0.0, 112) n/a n/a
   Ratner 1970b 107,822 0 0 0.0 (0.0, 34.2) 0.0 (0.0, 34.2) n/a n/a
   Summary 760,822 4 0 5.3 (1.4, 13.5) 0.0 (0.0, 4.8) 0.0 (0.0, 60.2)
All agesc          
   Neff 1967a 6,239,000 7 0 1.1 (0.4, 2.3) 0.0 (0.0, 0.6) 0.0 (0.0, 41.1)
   Neff 1967b 298,000 0 0 0.0 (0.0, 12.4) 0.0 (0.0, 12.4) n/a n/a
   Lane 1969 5,594,000 5 2 0.9 (0.3, 2.1) 0.4 (0.04, 1.3) 40.0 (5.3, 85.3)
   Lane 1970 596,000 1 0 1.7 (0.04, 9.3) 0.0 (0.0, 6.2) 0.0 (0.0, 97.5
   Mellin 1970 109,000 0 0 0.0 (0.0, 33.8) 0.0 (0.0, 33.8) n/a n/a
   Ratner 1970 369,546 0 0 0.0 (0.0, 10.0) 0.0 (0.0, 10.0) n/a n/a
   Neff 1972 549 0 0 0.0 (0.0, 6697) 0.0 (0.0, 6697) n/a n/a
   Summary 13,206,095 13 2 1.0 (0.5, 1.7) 0.2 (0.02, 0.5) 15.4 (1.9, 45.4)
  1. n/c = not calculated, n/a = not assessable aRisk and confidence intervals not calculated (n/c) for less that 100 vaccinations. Exact confidence intervals based on the binomial distribution. bThe Ratner study age groups, "Age 5 to 14" and "Age 15+", were counted in the Table age groups "Age 5 to 19" and "Age 20+", respectively. cAll ages group includes subjects whose age was unknown
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