Monkeypox primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Bassel Almarie, MD

Overview

The Advisory Committee on Immunization Practices recommends ACAM2000 or JYNNEOS as pre-exposure prophylaxis to individuals at risk of exposure to monkeypox on basis of an occupational assessment[1].

Pre-exposure Prophylaxis

There is no specific vaccine against monkeypox. Previous evidence showed that smallpox vaccine, which was administered to eradicate smallpox, provides cross-protection that is at least 85% effective in preventing monkeypox[2].

The Advisory Committee on Immunization Practices (ACIP) recommends ACAM2000 or JYNNEOS as pre-exposure prophylaxis to individuals at risk of exposure to monkeypox on basis of an occupational assessment[1].

  • ACAM2000 is an FDA approved active immunization against smallpox disease for persons determined to be at high risk for smallpox infection[3].
  • JYNNEOS (MVA-BN), also known as Imvamune or Imvanex, is an FDA approved vaccine to prevent monkeypox and smallpox in adults 18 years of age and older determined to be at high risk for smallpox or monkeypox infection[4].

The US Centers for Disease Control and Prevention (CDC), in conjunction with ACIP, recommends vaccination with ACAM2000 in non-emergency settings to[5]:

  • Labradorians performing diagnostic testing for monkeypox and military personnel
  • Persons investigating monkeypox outbreaks and involved in caring for infected individuals
  • Research laboratory personnel who directly handle cultures, contaminated animals or infected humans

CDC does not recommend pre-exposure vaccination for unexposed veterinarians, veterinary staff, or animal control officers, unless such persons are involved in field investigations.

In the UK, the UK Health Security Agent, in line with the UK Green Book "Immunization against Infectious Disease" policy, recommend JYNNEOS as pre-exposure therapy to individuals at risk of exposure on the basis of an occupational health assessment[6].

  • Pre-exposure vaccination with 2 doses of JYNNEOS with a minimum interval of 28 days

References

  1. 1.0 1.1 Rao AK, Petersen BW, Whitehill F, Razeq JH, Isaacs SN, Merchlinsky MJ; et al. (2022). "Use of JYNNEOS (Smallpox and Monkeypox Vaccine, Live, Nonreplicating) for Preexposure Vaccination of Persons at Risk for Occupational Exposure to Orthopoxviruses: Recommendations of the Advisory Committee on Immunization Practices - United States, 2022". MMWR Morb Mortal Wkly Rep. 71 (22): 734–742. doi:10.15585/mmwr.mm7122e1. PMID 35653347 Check |pmid= value (help).
  2. Fine PE, Jezek Z, Grab B, Dixon H (September 1988). "The transmission potential of monkeypox virus in human populations". International Journal of Epidemiology. 17 (3): 643–50. doi:10.1093/ije/17.3.643. PMID 2850277. |access-date= requires |url= (help)
  3. "ACAM2000 | FDA". Retrieved 2022-06-16.
  4. "JYNNEOS | FDA". Retrieved 2022-06-16.
  5. "Monkeypox and Smallpox Vaccine Guidance | Monkeypox | Poxvirus | CDC". Retrieved 2022-06-16.
  6. "assets.publishing.service.gov.uk" (PDF). Retrieved 2022-06-16.