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Smallpox (Vaccinia) Vaccine, Live is a live virus vaccine containing replication-competent vaccinia virus derived from the New York City Board of Health strain. It is used to induce active immunity against smallpox and mpox in high-risk individuals. The vaccine does not contain the variola virus (the causative agent of smallpox), but rather uses the related vaccinia virus to stimulate an immune response that cross-protects against variola. Upon percutaneous administration—typically with a bifurcated needle—the vaccinia virus replicates locally at the inoculation site and triggers both humoral and cellular immune responses. Neutralizing antibodies and memory B and T cells provide long-term protection[4][5][6]. ACAM2000 is currently approved for use in people at high risk for exposure to smallpox or mpox[1][3][4].
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