I think you're getting carried away with a theoretical risk. Remember, almost everyone in the world used to get vaccinia when smallpox was still around. This went on for not just for decades but over a century. The actual rate of complications was and is extremely low (only a handful of the tens of thousands of people who recently received the vaccine had any and all recovered quickly). Not only that but before vaccinia people used to innoculate themselves with smallpox itself! It was a traditional practice in the "Ottoman lands" (now mostly in Turkey) and spread to Europe. Even this caused very few deaths because the dose was controlled and the conditions of production and use ensured low virulence.

This is for me a fairly academic question because I feel the chances of terrorists obtaining and using smallpox are virtually nil and even if they do the chances they do so near me are also negligible. The almost zero risk from the vaccine therefore has to be seen in context of the even smaller risk of smallpox infection. Nonetheless I think the history of the technique speaks for itself.

 

This is a purely academic discussion for me as well. I was just trying to state that contact vaccina is not something to take lightly. As a person who has a skin disorder and will be in contact with patients in a hospital (chance of spreading it) it is a significant thing for me to consider.
I wasn't trying to get carried away but as i am training to become a medical professional these points were stressed in my classes in virology and tested heavily as well. There is a significant risk in the population especially with immunocompromised patients. The same goes for other live vaccines like varicella zoster and sabin polio vaccine if I recall.

 

Nice discussion, and good info from everyone! I should contribute some info, as well:

For every million people vaccinated in the past, between 14 and 52 had a life-threatning reaction to smallpox vaccine, and 1-2 died.

Severe rash on people with eczema or atopic dermatitis can occur(in as many as 1 per 26,000), which can lead to scarring or death.

Encephalitis may occur in 1 per 83,000, which can lead to permanent brain damage or death.

Severe progressive infection beginning at the vaccination site may occur in as many as 1 in 667,000, which can also lead to scarring or death.

Vaccinia Immune Globulin can help people who have serious reactions to smallpox vaccine. A second drug, cidofovir, may be used in some situations. Neither drug is currently licensed for this purpose, and they may have side effects of their own.

Treatment of severe reactions can be very expensive. Worker's Compensation or Health Insurance may not cover these expenses. There is no Federal program to reimburse you for time lost from work, either because of illness due to vaccination, or concern about spreading the virus to others.

-Pete