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In reply

Dr Smith and colleagues have provided a valuable update to recommendations regarding the use of vaccinia immune globulin (VIG) in the treatment of ocular complications of smallpox immunization that were not included in my recent succinct review.¹ This update includes the important personal communication to the authors from Dr Pavan-Langston that she has withdrawn her previous recommendation for the use of topical administration of VIG as well as the publication by the Centers for Disease Control (CDC) of revised recommendations for the use of intramuscular or intravenous VIG for ocular vaccinia.

Vaccinia immune globulin first became available in the late 1950s and represented a major therapeutic development for the treatment of complications of smallpox immunization. During the 1960s, intramuscular or intravenous VIG was increasingly used as a treatment for vaccinia keratitis, blepharitis, and other severe ocular involvement. While smallpox vaccination programs were still in effect in the 1970s, . . . [Full Text of this Article]

Richard D. Semba, MD, MPH

Correspondence: Dr Semba, Wilmer Eye Institute, Johns Hopkins University School of Medicine, 550 N Broadway, Suite 700, Baltimore, MD 21205 (rdsemba@jhmi.edu).

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