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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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BMC Public Health

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