Fatal generalized vaccinia with failure of antibody production and absence of serum gamma globulin.

The reaction to vaccination against smallpox is generally a trivial, short-lived affair. Complications are uncommon and, of these, generalized vaccinia is one of the least common. In true generahzed vaccima the lesions pass through the stages of papule, vesicle and pustule with little cropping, and the first lesions seldom occur earlier than the ninth day after vaccination. In most cases the disease is self-limiting, the lesions heal normally, and neutralizing antibodies develop during the course of the disease. A small number of cases have been reported, however, in which lesions continued to develop over