About 30 Washington County Hospital and Health Department workers will be vaccinated over the next few months, Health Officer William Christoffel said.
The vaccinations are being staggered because of the possibility that some who receive them will suffer side effects, Christoffel said.
Sandy Sullivan, a Health Department bioterrorism nurse coordinator, said the most common side effects are swollen lymph nodes, a low-grade fever and itchiness in the area punctured.
Keyser said he vaccinated hundreds of children for smallpox between 1960 and 1972, when routine vaccination was halted in the United States, he said.
With the vaccinations, Keyser said, he and the county will be better prepared in the case of a smallpox outbreak, and the damage a terrorist attack involving smallpox could do to the area would be lessened.
The vaccinations are a precautionary measure and there is no expectation that the area will experience a smallpox outbreak, Christoffel said.
County residents should feel comfort, not anxiety, about the fact some residents are being vaccinated because it means preparations have been made, Sullivan said.
The first of the four to be vaccinated was Julie Garver, a registered nurse. Keyser, following the federal protocol, punctured her skin 15 times to administer the vaccine.
"Julie, you are making history here: The first person in Washington County to be vaccinated for smallpox in 30-something years," Keyser said.
"Now, who is next?" he asked.
"You are," Garver said. She vaccinated him, while he made recommendations on the best way to puncture his skin.
A health care worker asked Garver if the punctures hurt.
"No," she said. "Not too bad."
Those receiving the vaccine are asked to wear a dressing and a sleeve over the poked area until a scab that develops falls off, which usually takes about 21 days, Sullivan said.
The employees who received the vaccine are scheduled to work the same hours as they normally would, Christoffel said.
The vaccinated employees have been asked to keep a daily log listing any health changes that might be related to the inoculation, Sullivan said. The logs will be given to the federal government for research purposes, she said.
Based on studies from the 1960s, experts estimate that one or two out of every 1 million people who get the vaccine for the first time will die, and about 15 will face life-threatening illness.
The incubation period for smallpox is about 12 days following exposure, according to the U.S. Department of Health and Human Services.
Initial symptoms include high fever, fatigue, headaches and backaches. A characteristic rash, most prominent on the face, arms and legs, follows in two to three days.
The disease, which has not been reported in the United States for decades, was declared eradicated worldwide in 1980, but experts fear it could be intentionally released by terrorists or a hostile nation.