To examine oral shedding of vaccinia in volunteers who were recently vaccinated against smallpox, pharyngeal swabs were collected for viral culture between days 3 and 5 and days 6 and 8 after vaccination with diluted Sanofi Pasteur smallpox vaccine. From 102 adult volunteers (48 vaccinia-naive, 54 vaccinia-experienced), vaccinia was not detected in any specimen (0/201, 95% confidence interval, 0-1.8), which suggests a lack of oral shedding of vaccinia after immunization. This supports recommendations that individuals who were recently vaccinated against smallpox do not require placement in airborne or droplet precautions.