Vaccination for monkeypox prevention in persons with high-risk sexual behaviours to control on-going outbreak of monkeypox virus clade 3.

Petersen, Eskild; Zumla, Alimuddin; Hui, David S.; Blumberg, Lucille; Valdoleiros, Sofia R; Amao, Lateefat Kikelomo; Ntoumi, Francine; Asogun, Danny; Simonsen, L; Haider, Najmul; Traore, Tieble; Kapata, Nathan; Dar, Osman; Nachega, J; Abbara, Aula; Balushi, A Al; Kock, Richard; Maeurer, M; Lee, S S; Lucey, D R; Ippolito, Giuseppe; Koopmans, Mpg

doi:10.1016/j.ijid.2022.06.047

Cited by 59 publications

(69 citation statements)

References 11 publications

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“…During each simulation a predicted (integer) number of reported cases for MSM and non-MSM on each week was generated using equation (5):…”

Section: The True Data Wasmentioning

confidence: 99%

“…There has been sustained incidence of monkeypox virus (MPXV) in European and North American countries since May 2022, leading to a WHO declaration of a public health emergency of international concern on 23rd July 2022 [1]. It is likely that vaccines developed to target smallpox have reasonable efficacy against MPXV-induced disease [2][3][4], and given the significant skew in cases towards men-who-have-sex-with-men (MSM) it has been suggested that vaccines developed against MPXV should be offered as pre-exposure prophylactic (PrEP) targetted at this group [5]. Towards this goal the UK Health Security Agency (UKHSA) and the Joint Committee on Vaccination and Immunisation (JCVI) have recommended the use of the Modified Vaccinia Ankara (MVA) smallpox vaccine Imvanex (called Jynneos in the USA) for at-risk groups for monkeypox in the UK [6].…”

Section: Introductionmentioning

confidence: 99%

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The role of vaccination and public awareness in medium-term forecasts of monkeypox incidence in the United Kingdom

Brand

Cavallaro

Hilton

et al. 2022

Preprint

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Monkeypox virus (MPXV) is spreading rapidly through close human-to-human contact primarily amongst communities of men-who-have-sex-with-men (MSM). Behavioural change arising from increased knowledge and health warnings may decelerate the rate of transmission and Vaccinia-based vaccination is likely to be an effective longer-term intervention. Here we investigate the current epidemic within the UK population and simulate control options over a 12 week projection using a stochastic discrete-population transmission model which includes MSM status, rate of formation of new sexual partners, and an underlying random sized metapopulation structure. We find that the virus may have already infected a significant proportion of the MSM group with the highest sexual activity (32.5%; 15.9% - 44.9% prediction IQR); the associated immunity, albeit among groups that form a small but sexually active part of the MSM community in the UK, coupled to behavioural driven decrease in the transmission rate of individuals infected with monkeypox, leads to case incidence flattening and then declining over the projection period (12 weeks). Vaccination is most beneficial when targeted to MSM with highest activity if delivered in the near term to further interrupt transmission amongst those driving the epidemic.

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“…During each simulation a predicted (integer) number of reported cases for MSM and non-MSM on each week was generated using equation (5):…”

Section: The True Data Wasmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The role of vaccination and public awareness in medium-term forecasts of monkeypox incidence in the United Kingdom

Brand

Cavallaro

Hilton

et al. 2022

Preprint

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“…This vaccine is a non-replicating live vaccine containing a live modified form of the vaccinia Ankara virus (MVA), produced by Bavarian Nordik and authorized since 2013 in Europe under the trade name IMVANEX® 8,17 . Vaccination after a Monkeypox exposure may help to prevent the onset of the disease or make it less severe [18][19][20] . In the context of the current outbreak, early post-exposure ring vaccination (EPRV) with smallpox vaccine (offlabel use) has been recommended by WHO, USA Centers for Disease Control & Prevention (CDC) and France to reduce symptoms of Monkeypox disease and to limit transmission 8,[21][22][23][24] .…”

Section: Introductionmentioning

confidence: 99%

Breakthrough infections after post-exposure vaccination against Monkeypox

Peiffer-Smadja

Thy

Kramer

et al. 2022

Preprint

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Background A third-generation smallpox vaccine was recommended in France for individuals who had a high-risk contact with a PCR-confirmed Monkeypox patient. We aimed to describe the outcomes of high-risk contacts receiving third-generation smallpox vaccine as an early post-exposure ring vaccination (EPRV) especially tolerance and potential breakthrough infections after the first dose. Methods We performed an observational analysis of all consecutive individuals vaccinated with the IMVANEX smallpox vaccine after a high-risk contact defined as close skin-to-skin or mucosal contact and/or indirect contact on textile or surface and/or droplets exposure defined by a contact at less than 2 meters during at least 3 hours with a PCR-confirmed Monkeypox patient. Results Between May 27th and July 13th, 2022, 276 individuals received one dose of IMVANEX with a median delay of 11 days [IQR 8-14] after exposure with a confirmed Monkeypox patient. Mode of exposure was droplets for 240 patients (91%), indirect contact for 189 (71%) and unprotected sexual intercourse for 146 (54%). Most of the patients were men (91%, n=250) and men who have sex with men (88%, n=233). The vaccine was well tolerated with no severe adverse event. Among the 276 vaccinated individuals, 12 (4%) had a confirmed Monkeypox breakthrough infection with no severe infection. Ten out of 12 patients developed a Monkeypox infection in the five days following vaccination and two had a breakthrough infection at 22 and 25 days. Conclusion EPRV with a third-generation smallpox vaccine was well tolerated and effective against Monkeypox but did not completely prevent breakthrough infections.

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“…Should we be worried? In this outbreak, the reproduction number (R0) for MPXV seems to be higher than 1; therefore, in high-risk populations, including MSM, an expanding outbreak is likely [ 16 ]. On the other side, more than 16,000 people have been infected worldwide and 5 persons have died (i.e., case fatality rate 0.03%), overwhelmingly belonging to the MSM community.…”

mentioning

confidence: 99%