A new reports says that up to half of all U.S. residents may be ineligible for smallpox vaccination because of the growing incidence of eczema. In a report appearing in the September issue of the Journal of Allergy and Clinical Immunology, Dr. Renata J.M. Engler from the Walter Reed Army Medical Center in Washington, DC, and colleagues note that in people with eczema, exposure to vaccinia — a relative of smallpox used to inoculate people — or even contact with someone who was recently vaccinated can cause a condition that can lead to scarring, blindness and even death. “A major challenge lies in the ability to protect the population from the disease while minimizing the considerable side effects from the vaccine,” Reuters quotes from their report. The researchers say more studies should be conducted to help identify people who are prone to side vaccinia effects. Others who should avoid smallpox vaccination include people with immune deficiency diseases such as AIDS, and those on immune system-suppressing drugs, such as transplant patients.