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Pischel L, Martini BA, Yu N, Cacesse D, Tracy M, Kharbanda K, Ahmed N, Patel KM, Grimshaw AA, Malik AA, Goshua G, Omer SB. Vaccine effectiveness of 3rd generation mpox vaccines against mpox and disease severity: A systematic review and meta-analysis. Vaccine 2024; 42:126053. [PMID: 38906763 DOI: 10.1016/j.vaccine.2024.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION Before the global mpox outbreak which began in 2022, the real-world vaccine effectiveness (VE) of mpox vaccines was unknown. We quantified the VE in the global population of 3rd generation or later mpox vaccines (MVA-BN, LC16m8, OrthopoxVac) compared with unvaccinated or other vaccinated states for infection, hospitalization and death. VE was stratified by 1-dose and 2-doses and post-exposure prophylaxis (PEP). METHODS Studies were included if they measured vaccine efficacy or effectiveness in humans. Animal studies and immunogenicity studies were excluded. MEDLINE, Web of Science, Google Scholar, Embase, MedRxiv and grey literature were searched from January 1st, 1970, with the last search run on November 3, 2023 (Prospero, CRD42022345240). Risk of publication bias was assessed via funnel plots and Egger's test, and study quality via Newcastle-Ottawa scales. RESULTS A total of 11,892 records were identified via primary search, 3,223 via citation chasing. Thirty-three studies were identified of 3rd generation vaccines, 32 of which were MVA-BN. Two additional studies were re-analysis of existing data. Most of these studies were focused on gay, bisexual, or other men who have sex with men between the ages of 18-49 in May to October of 2022. VE of 1 dose of MVA-BN was 76% (95%CI 64-88%) from twelve studies. VE of 2 doses was 82% (95%CI 72-92%) from six studies. VE of MVA-BN PEP against mpox was 20% (95%CI -24-65%) from seven studies. All VE are calculated from random effects estimates. 18/33(55%) studies were rated as poor, 3/33(9%) as fair and 12/33(36%) as good. Studies included in the meta-analysis had higher quality: 11/16 (69%) were rated as good quality. CONCLUSION Both 1 and 2 doses of MVA-BN are highly effective at preventing mpox. Effectiveness estimates, specifically of PEP are limited by immortal time bias, predominant mode of mpox transmission, and real-world vaccine timing of administration.
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Affiliation(s)
- Lauren Pischel
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA.
| | | | - Natalle Yu
- Yale School of Medicine, Department of Internal Medicine, New Haven, CT, USA
| | | | - Mahder Tracy
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern, Dallas, TX, USA
| | - Kolambi Kharbanda
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern, Dallas, TX, USA
| | - Noureen Ahmed
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern, Dallas, TX, USA
| | - Kavin M Patel
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | - Alyssa A Grimshaw
- Yale University, Harvey Cushing/John Hay Whitney Medical Library, New Haven, CT, USA
| | - Amyn A Malik
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern, Dallas, TX, USA
| | - George Goshua
- Yale School of Medicine, Section of Hematology, Department of Internal Medicine and Yale Cancer Center, New Haven, CT, USA; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
| | - Saad B Omer
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern, Dallas, TX, USA
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Ghosn J, Assoumou L, Ouattara M, Rubenstein E, Pialoux G, Katlama C, Surgers L, Duvivier C, Pavie J, Viard JP, Algarte-Genin M, Gibowski S, Ollivier M, Costagliola D, Molina JM. Impact of vaccination with third generation modified vaccinia Ankara and sexual behaviour on mpox incidence in men who have sex with men: analysis among participants of the ANRS-174 DOXYVAC trial. THE LANCET REGIONAL HEALTH. EUROPE 2024; 45:101020. [PMID: 39188858 PMCID: PMC11345388 DOI: 10.1016/j.lanepe.2024.101020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 07/17/2024] [Accepted: 07/18/2024] [Indexed: 08/28/2024]
Abstract
Background Mpox was first reported in France on May 19 and third-generation live Modified Vaccinia Ankara (MVA-BN) vaccination of multiple-partner men who have sex with men (MSM) was recommended as of July 11, 2022. We assessed the impact of vaccination and of sexual behavior adopted during the epidemic period on mpox incidence in the ANRS-174-DOXYVAC trial enrolling MSM on HIV pre-exposure prophylaxis (PrEP) with history of sexually-transmitted infections (STI) in the previous year. Methods We compared pre-epidemic socio-behavioral characteristics and change in sexual behaviors after the onset of the epidemic of participants with mpox and mpox-free. Then we compared incidence rates of mpox per 1000 person-months (p-m) between May 9-July 10 (before vaccination of MSM, period-1) and July 11-September 20 2022 (after vaccination launch, period-2) and explored factors explaining the period effect using Poisson regression model. Findings 472 MSM had data before and after May 9, 2022. Twenty percent had received smallpox vaccine during childhood. Mpox occurred in 77/472 participants (incidence 49.3 per 1000 p-m (95% CI 38.9-61.6)). MVA-BN vaccination roll-out was rapid, with 86% (341/398) of eligible participants having received at least one dose by September 20, 2022. Sexual behavior significantly changed before and after May 9, with a decrease in the proportion of mpox-free participants with >10 partners during last 3 months (45% vs 38%, p = 0.0035). Mpox incidence was 67.4 per 1000 p-m (95% CI 51.6-86.6) in period-1, and 24.4 per 1000 p-m (95% CI 13.9-39.6) in period-2, with an incidence rate ratio of 0.36 (95% CI 0.21-0.63). In multivariable Poisson regression model, only MVA-BN vaccination in 2022 remained significantly associated with mpox incidence, with a 99% risk reduction (95% CI 96.6-99.7). Interpretation In MSM on PrEP enrolled in the ANRS-174-DOXYVAC trial, rapid roll-out of MVA-BN vaccination was associated with a strong reduction in mpox incidence. Funding ANRS Maladies Infectieuses Emergentes (ANRS/MIE).
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Affiliation(s)
- Jade Ghosn
- Assistance Publique-Hôpitaux de Paris.Nord, Hôpital Bichat-Claude Bernard, Service des Maladies Infectieuses et Tropicales, Paris F75018, France
- Université Paris Cité, INSERM, UMRS 1137 IAME, Paris F75018, France
| | - Lambert Assoumou
- Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris F75012, France
| | - Moussa Ouattara
- Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris F75012, France
| | - Emma Rubenstein
- Assistance Publique-Hôpitaux de Paris, Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, Paris F75010, France
| | - Gilles Pialoux
- Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Service des Maladies Infectieuses et Tropicales, Hôpital Tenon, Paris F75020, France
| | - Christine Katlama
- Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris F75012, France
- Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Service des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, Paris F75013, France
| | - Laure Surgers
- Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris F75012, France
- Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris F75012, France
| | - Claudine Duvivier
- Assistance Publique-Hôpitaux de Paris-Necker Hospital, Infectious Diseases Department, Necker-Pasteur Infectiology Center, Paris F75015, France
- Université Paris Cité, INSERM U1016, CNRS UMR8104, Institut Cochin, Paris, France
- IHU Imagine, Paris, France
| | - Juliette Pavie
- Assistance Publique-Hôpitaux de Paris-Centre, Unité de Thérapeutique en Immuno-Infectiologie, Hôpital Hôtel-Dieu, Paris F75004, France
| | - Jean-Paul Viard
- Assistance Publique-Hôpitaux de Paris-Centre, Unité de Thérapeutique en Immuno-Infectiologie, Hôpital Hôtel-Dieu, Paris F75004, France
| | - Michèle Algarte-Genin
- Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris F75012, France
| | - Severine Gibowski
- Agence Nationale de Recherche sur le SIDA et les Hépatites virales – Maladies Infectieuses et Émergentes (ANRS-MIE), Paris F75015, France
| | - Manon Ollivier
- Agence Nationale de Recherche sur le SIDA et les Hépatites virales – Maladies Infectieuses et Émergentes (ANRS-MIE), Paris F75015, France
| | - Dominique Costagliola
- Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris F75012, France
| | - Jean-Michel Molina
- Assistance Publique-Hôpitaux de Paris, Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, Paris F75010, France
- Université Paris Cité, INSERM UMR 944, Paris F75010, France
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Otmar CD, Merolla AJ. Social Determinants of Message Exposure and Health Anxiety Among Young Sexual Minority Men in the United States During the 2022 Mpox Outbreak. HEALTH COMMUNICATION 2024:1-12. [PMID: 39225351 DOI: 10.1080/10410236.2024.2397272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
This study tested the structural influence model of communication in the context of the 2022 global outbreak of the Mpox virus among young sexual minority men. The primary objective was to understand how distinct social determinants, including education, race/ethnicity, and interpersonal discrimination, influenced exposure to Mpox messages in daily life and affected health anxiety concerning the Mpox virus in the United States. We also explored the significance of LGBTQ+ community connectedness as a crucial form of social capital during the outbreak. We collected a three-wave longitudinal dataset and examined within-person and between-person associations using a random-intercept cross-lagged panel model. Participants (N = 254) reported that internet sources and social media were their primary information sources for Mpox messages during the outbreak. Educational attainment, racial minority status, and LGBTQ+ community connectedness were significantly associated with message exposure. Young sexual minority men who faced greater interpersonal discrimination in their daily lives also reported higher rates of Mpox-related health anxiety. Longitudinal analysis indicated that (at the within-person level) Mpox anxiety was significantly associated with greater Mpox message exposure in the month following the outbreak, but that relationship waned in the subsequent month. The theoretical implications highlight the relevance of minority stress variables in the structural influence model of communication framework and suggest the importance of community connectedness as a distinct form of social capital shaping message exposure and health anxiety during the Mpox outbreak in the United States.
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Affiliation(s)
| | - Andy J Merolla
- Department of Communication, University of California, Santa Barbara
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Mahmoodi S, Amirzakaria JZ, Ghasemian A. A novel multi-epitope peptide vaccine targeting immunogenic antigens of Ebola and monkeypox viruses with potential of immune responses provocation in silico. Biotechnol Appl Biochem 2024. [PMID: 39128888 DOI: 10.1002/bab.2646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 07/10/2024] [Indexed: 08/13/2024]
Abstract
The emergence or reemergence of monkeypox (Mpox) and Ebola virus (EBOV) agents causing zoonotic diseases remains a huge threat to human health. Our study aimed at designing a multi-epitope vaccine (MEV) candidate to target both the Mpox and EBOV agents using immunoinformatics tools. Viral protein sequences were retrieved, and potential nonallergenic, nontoxic, and antigenic epitopes were obtained. Next, cytotoxic and helper T-cell (CTL and HTL, respectively) and B-cell (BCL) epitopes were predicted, and those potential epitopes were fused utilizing proper linkers. The in silico cloning and expression processes were implemented using Escherichia coli K12. The immune responses were prognosticated using the C-ImmSim server. The MEV construct (29.53 kDa) included four BCL, two CTL, and four HTL epitopes and adjuvant. The MEV traits were pertinent in terms of antigenicity, non-allergenicity, nontoxicity, physicochemical characters, and stability. The MEV candidate was also highly expressed in E. coli K12. The strong affinity of MEV-TLR3 was confirmed using molecular docking and molecular dynamics simulation analyses. Immune simulation analyses unraveled durable activation and responses of cellular and humoral arms alongside innate immune responses. The designed MEV candidate demonstrated appropriate traits and was promising in the prediction of immune responses against both Mpox and EBOV agents. Further experimental assessments of the MEV are required to verify its efficacy.
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Affiliation(s)
- Shirin Mahmoodi
- Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Javad Zamani Amirzakaria
- Department of Plant Biotechnology, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Abdolmajid Ghasemian
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
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Li J, Li X, Dong J, Wei J, Guo X, Wang G, Xu M, Zhao A. Enhanced Immune Responses in Mice by Combining the Mpox Virus B6R-Protein and Aluminum Hydroxide-CpG Vaccine Adjuvants. Vaccines (Basel) 2024; 12:776. [PMID: 39066415 PMCID: PMC11281346 DOI: 10.3390/vaccines12070776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 07/12/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Novel adjuvants and innovative combinations of adjuvants (Adjuvant Systems) have facilitated the development of enhanced and new vaccines against re-emerging and challenging pathogenic microorganisms. Nonetheless, the efficacy of adjuvants is influenced by various factors, and the same adjuvant may generate entirely different immune responses when paired with different antigens. Herein, we combined the MPXV-B6R antigen with BC02, a novel adjuvant with proprietary technology, to assess its capability to induce both cellular and humoral immunity in mouse models. Mice received two intramuscular injections of B6R-BC02, which resulted in the production of MPXV-specific IgG, IgG1, and IgG2a antibodies. Additionally, it elicited strong MPXV-specific Th1-oriented cellular immunity and persistent effector memory B-cell responses. The advantages of BC02 were further validated, including rapid initiation of the immune response, robust recall memory, and sustained immune response induction. Although the potential of immunized mice to produce serum-neutralizing antibodies against the vaccinia virus requires further improvement, the exceptional performance of BC02 as an adjuvant for the MPXV-B6R antigen has been consistently demonstrated.
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Affiliation(s)
- Junli Li
- Division of Tuberculosis Vaccine and Allergen Products, Institute of Biological Product Control, National Institutes for Food and Drug Control, Beijing 102629, China; (J.L.); (X.L.); (J.D.); (J.W.); (X.G.); (G.W.); (M.X.)
- Key Laboratory for Quality Research and Evaluation of Biological Products, National Medical Products Administration (NMPA), Beijing 102629, China
- Key Laboratory of Research on Quality and Standardization of Biotech Products, National Health Commission (NHC), Beijing 102629, China
| | - Xiaochi Li
- Division of Tuberculosis Vaccine and Allergen Products, Institute of Biological Product Control, National Institutes for Food and Drug Control, Beijing 102629, China; (J.L.); (X.L.); (J.D.); (J.W.); (X.G.); (G.W.); (M.X.)
- Key Laboratory for Quality Research and Evaluation of Biological Products, National Medical Products Administration (NMPA), Beijing 102629, China
- Key Laboratory of Research on Quality and Standardization of Biotech Products, National Health Commission (NHC), Beijing 102629, China
| | - Jiaxin Dong
- Division of Tuberculosis Vaccine and Allergen Products, Institute of Biological Product Control, National Institutes for Food and Drug Control, Beijing 102629, China; (J.L.); (X.L.); (J.D.); (J.W.); (X.G.); (G.W.); (M.X.)
- Key Laboratory for Quality Research and Evaluation of Biological Products, National Medical Products Administration (NMPA), Beijing 102629, China
- Key Laboratory of Research on Quality and Standardization of Biotech Products, National Health Commission (NHC), Beijing 102629, China
| | - Jiazheng Wei
- Division of Tuberculosis Vaccine and Allergen Products, Institute of Biological Product Control, National Institutes for Food and Drug Control, Beijing 102629, China; (J.L.); (X.L.); (J.D.); (J.W.); (X.G.); (G.W.); (M.X.)
- College of Life Sciences and Biopharmaceuticals, Shenyang Pharmaceutical University, Shenyang 117004, China
| | - Xiaonan Guo
- Division of Tuberculosis Vaccine and Allergen Products, Institute of Biological Product Control, National Institutes for Food and Drug Control, Beijing 102629, China; (J.L.); (X.L.); (J.D.); (J.W.); (X.G.); (G.W.); (M.X.)
- Key Laboratory for Quality Research and Evaluation of Biological Products, National Medical Products Administration (NMPA), Beijing 102629, China
- Key Laboratory of Research on Quality and Standardization of Biotech Products, National Health Commission (NHC), Beijing 102629, China
| | - Guozhi Wang
- Division of Tuberculosis Vaccine and Allergen Products, Institute of Biological Product Control, National Institutes for Food and Drug Control, Beijing 102629, China; (J.L.); (X.L.); (J.D.); (J.W.); (X.G.); (G.W.); (M.X.)
- Key Laboratory for Quality Research and Evaluation of Biological Products, National Medical Products Administration (NMPA), Beijing 102629, China
- Key Laboratory of Research on Quality and Standardization of Biotech Products, National Health Commission (NHC), Beijing 102629, China
| | - Miao Xu
- Division of Tuberculosis Vaccine and Allergen Products, Institute of Biological Product Control, National Institutes for Food and Drug Control, Beijing 102629, China; (J.L.); (X.L.); (J.D.); (J.W.); (X.G.); (G.W.); (M.X.)
- Key Laboratory for Quality Research and Evaluation of Biological Products, National Medical Products Administration (NMPA), Beijing 102629, China
- Key Laboratory of Research on Quality and Standardization of Biotech Products, National Health Commission (NHC), Beijing 102629, China
| | - Aihua Zhao
- Division of Tuberculosis Vaccine and Allergen Products, Institute of Biological Product Control, National Institutes for Food and Drug Control, Beijing 102629, China; (J.L.); (X.L.); (J.D.); (J.W.); (X.G.); (G.W.); (M.X.)
- Key Laboratory for Quality Research and Evaluation of Biological Products, National Medical Products Administration (NMPA), Beijing 102629, China
- Key Laboratory of Research on Quality and Standardization of Biotech Products, National Health Commission (NHC), Beijing 102629, China
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Fresse A, Massy N, Fournier D, Pinel S, Beurrier M, Antoine ML, Petitpain N, Gillet P. Adverse drug reaction profile of third-generation smallpox vaccines used in France during the 2022 monkeypox epidemic. AIDS 2024; 38:768-771. [PMID: 38482909 DOI: 10.1097/qad.0000000000003838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
Due to the start of the monkeypox epidemic in 2022, we retrospectively analyzed the adverse drug reactions (ADRs) reported in France after monkeypox vaccinations with the third-generation smallpox vaccine. Ninety-eight cases, representing 172 ADRs, were reported. ADRs were mostly expected reactogenicity reactions occurring within days after the first dose of vaccine and having a quick favorable outcome. Unexpected facial palsy and vaccination failure are discussed.
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Affiliation(s)
- Audrey Fresse
- Laboratoire de Pharmacologie-Toxicologie, Pharmacovigilance & Centre d'évaluation et d'information sur la Pharmacodépendance-Addictovigilance, Centre Hospitalier Régional et Universitaire de Nancy Brabois, Bâtiment de Biologie Médicale et de Biopathologie, Vandœuvre-Lès-Nancy
| | - Nathalie Massy
- Regional Pharmacovigilance Center, Department of Pharmacology, CHU Rouen, Rouen
| | - Dorine Fournier
- Regional Pharmacovigilance Center Pitié-Saint Antoine, Pitié-Salpêtrière Hospital, GH Sorbonne-Université
| | - Sylvine Pinel
- Regional Pharmacovigilance Center Paris Saint-Louis, Fernand Widal Hospital, APHP
| | - Mathilde Beurrier
- Laboratoire de Pharmacologie-Toxicologie, Pharmacovigilance & Centre d'évaluation et d'information sur la Pharmacodépendance-Addictovigilance, Centre Hospitalier Régional et Universitaire de Nancy Brabois, Bâtiment de Biologie Médicale et de Biopathologie, Vandœuvre-Lès-Nancy
| | - Marie-Lauren Antoine
- Laboratoire de Pharmacologie-Toxicologie, Pharmacovigilance & Centre d'évaluation et d'information sur la Pharmacodépendance-Addictovigilance, Centre Hospitalier Régional et Universitaire de Nancy Brabois, Bâtiment de Biologie Médicale et de Biopathologie, Vandœuvre-Lès-Nancy
- Nancy Regional University Hospital Center, Clinical Trial Vigilance Unit, Vandoeuvre-lès-Nancy
| | - Nadine Petitpain
- Laboratoire de Pharmacologie-Toxicologie, Pharmacovigilance & Centre d'évaluation et d'information sur la Pharmacodépendance-Addictovigilance, Centre Hospitalier Régional et Universitaire de Nancy Brabois, Bâtiment de Biologie Médicale et de Biopathologie, Vandœuvre-Lès-Nancy
- Nancy Regional University Hospital Center, Clinical Trial Vigilance Unit, Vandoeuvre-lès-Nancy
| | - Pierre Gillet
- Laboratoire de Pharmacologie-Toxicologie, Pharmacovigilance & Centre d'évaluation et d'information sur la Pharmacodépendance-Addictovigilance, Centre Hospitalier Régional et Universitaire de Nancy Brabois, Bâtiment de Biologie Médicale et de Biopathologie, Vandœuvre-Lès-Nancy
- Université de Lorraine, Centre National de la Recherche Scientifique, Ingénierie Moléculaire et Physiopathologie Articulaire, Nancy, France
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Yan H, Peng Y, Zhang J, Peng R, Feng X, Su J, Yi H, Lu Y, Gao S, Liu J, Yang M, Liu X, Gao S, Chen Z. Rapid and highly potent humoral responses to mpox nanovaccine candidates adjuvanted by thermostable scaffolds. Vaccine 2024; 42:2072-2080. [PMID: 38423815 DOI: 10.1016/j.vaccine.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/29/2024] [Accepted: 02/07/2024] [Indexed: 03/02/2024]
Abstract
Monkeypox (mpox) is a zoonotic disease caused by monkeypox virus (MPXV) of the orthopoxvirus genus. The emergence and global spread of mpox in 2022 was declared as a public health emergency by World Health Organization. This mpox pandemic alarmed us that mpox still threaten global public health. Live vaccines could be used for immunization for this disease with side effects. New alternative vaccines are urgently needed for this re-emerging disease. Specific antibody responses play key roles for protection against MPXV, therefore, vaccines that induce high humoral immunity will be ideal candidates. In the present study, we developed thermostable nanovaccine candidates for mpox by conjugating MPXV antigens with thermostable nanoscafolds. Three MPXV protective antigens, L1, A29, and A33, and the thermostable Aquafex aeolicus lumazine synthase (AaLS), were expressed in E. coli and purified by Ni-NTA methods. The nanovaccines were generated by conjugation of the antigens with AaLS. Thermal stability test results showed that the nanovaccines remained unchanged after one week storage under 37℃ and only partial degradation under 60℃, indicating high thermostability. Very interesting, one dose immunization with the nanovaccine could induce high potent antibody responses, and two dose induced 2-month high titers of antibodes. In vitro virus neutralization test showed that nanovaccine candidates induced significantly higher levels of neutralization antibodies than monomers. These results indicated that the AaLS conjugation nanovaccines of MPXV antigens are highly thermostable in terms of storage and antigenic, being good alternative vaccine candidates for this re-emerging disease.
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Affiliation(s)
- Haozhen Yan
- One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China; NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, Guangzhou 510080, China; Key Laboratory of Tropical Diseases Control, Sun Yat-Sen University, Ministry of Education, Guangzhou 510080, China
| | - Yuanli Peng
- One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China; NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, Guangzhou 510080, China; Key Laboratory of Tropical Diseases Control, Sun Yat-Sen University, Ministry of Education, Guangzhou 510080, China
| | - Jinsong Zhang
- One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China; NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, Guangzhou 510080, China; Key Laboratory of Tropical Diseases Control, Sun Yat-Sen University, Ministry of Education, Guangzhou 510080, China
| | - Ruihao Peng
- One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China; NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, Guangzhou 510080, China; Key Laboratory of Tropical Diseases Control, Sun Yat-Sen University, Ministry of Education, Guangzhou 510080, China
| | - XiangNing Feng
- One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China; NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, Guangzhou 510080, China; Key Laboratory of Tropical Diseases Control, Sun Yat-Sen University, Ministry of Education, Guangzhou 510080, China
| | - JiaYue Su
- One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China; NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, Guangzhou 510080, China; Key Laboratory of Tropical Diseases Control, Sun Yat-Sen University, Ministry of Education, Guangzhou 510080, China
| | - HuaiMin Yi
- One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China; NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, Guangzhou 510080, China; Key Laboratory of Tropical Diseases Control, Sun Yat-Sen University, Ministry of Education, Guangzhou 510080, China
| | - Yuying Lu
- One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China; NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, Guangzhou 510080, China; Key Laboratory of Tropical Diseases Control, Sun Yat-Sen University, Ministry of Education, Guangzhou 510080, China
| | - Shan Gao
- One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China; NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, Guangzhou 510080, China; Key Laboratory of Tropical Diseases Control, Sun Yat-Sen University, Ministry of Education, Guangzhou 510080, China
| | - Jinsong Liu
- One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China; NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, Guangzhou 510080, China; Key Laboratory of Tropical Diseases Control, Sun Yat-Sen University, Ministry of Education, Guangzhou 510080, China
| | - Mingwei Yang
- One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China; NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, Guangzhou 510080, China; Key Laboratory of Tropical Diseases Control, Sun Yat-Sen University, Ministry of Education, Guangzhou 510080, China
| | - Xinrui Liu
- One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China; NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, Guangzhou 510080, China; Key Laboratory of Tropical Diseases Control, Sun Yat-Sen University, Ministry of Education, Guangzhou 510080, China
| | - Shenyang Gao
- Collaborative Innovation Center for Prevention and Control of Zoonoses, Jinzhou Medical University. Jinzhou 121001, China
| | - Zeliang Chen
- One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China; NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, Guangzhou 510080, China; Key Laboratory of Tropical Diseases Control, Sun Yat-Sen University, Ministry of Education, Guangzhou 510080, China; Key Laboratory of Zoonose Prevention and Control at Universities of Inner Mongolia Autonomous Region, Medical College, Inner Mongolia Minzu University, Tongliao 028000, China; Collaborative Innovation Center for Prevention and Control of Zoonoses, Jinzhou Medical University. Jinzhou 121001, China.
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8
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Guzzetta G, Marziano V, Mammone A, Siddu A, Ferraro F, Caraglia A, Maraglino F, Rezza G, Vespignani A, Longini I, Ajelli M, Merler S. The decline of the 2022 Italian mpox epidemic: Role of behavior changes and control strategies. Nat Commun 2024; 15:2283. [PMID: 38480715 PMCID: PMC10937928 DOI: 10.1038/s41467-024-46590-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/01/2024] [Indexed: 03/17/2024] Open
Abstract
In 2022, a global outbreak of mpox occurred, predominantly impacting men who have sex with men (MSM). The rapid decline of this epidemic is yet to be fully understood. We investigated the Italian outbreak by means of an individual-based mathematical model calibrated to surveillance data. The model accounts for transmission within the MSM sexual contact network, in recreational and sex clubs attended by MSM, and in households. We indicate a strong spontaneous reduction in sexual transmission (61-87%) in affected MSM communities as the possible driving factor for the rapid decline in cases. The MSM sexual contact network was the main responsible for transmission (about 80%), with clubs and households contributing residually. Contact tracing prevented about half of the potential cases, and a higher success rate in tracing contacts could significantly amplify its effectiveness. Notably, immunizing the 23% of MSM with the highest sexual activity (10 or more partners per year) could completely prevent new mpox resurgences. This research underscores the importance of augmenting contact tracing, targeted immunization campaigns of high-risk groups, and fostering reactive behavioral changes as key strategies to manage and prevent the spread of emerging sexually transmitted pathogens like mpox within the MSM community.
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Affiliation(s)
- Giorgio Guzzetta
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | | | - Alessia Mammone
- Health Prevention Directorate, Ministry of Health, Rome, Italy
| | - Andrea Siddu
- Health Prevention Directorate, Ministry of Health, Rome, Italy
| | | | - Anna Caraglia
- Health Prevention Directorate, Ministry of Health, Rome, Italy
| | | | - Giovanni Rezza
- Health Prevention Directorate, Ministry of Health, Rome, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Alessandro Vespignani
- Laboratory for the Modeling of Biological and Socio-Technical Systems, Northeastern University, Boston, MA, USA
| | - Ira Longini
- Department of Biostatistics, Colleges of Public Health and Health Professions, and Medicine, University of Florida, Gainesville, FL, USA
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Stefano Merler
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy.
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9
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Jiang W, Hu Y, Yang X, Hou L, Zhang J, Niu H, Hu C, Lin J. Breakthrough infection and reinfection in patients with mpox. Rev Med Virol 2024; 34:e2522. [PMID: 38348583 DOI: 10.1002/rmv.2522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/27/2024] [Accepted: 02/03/2024] [Indexed: 02/15/2024]
Abstract
Recently, patients with Mpox breakthrough infection or reinfection were constantly reported. However, the induction, risk factors, and important clinical symptoms of breakthrough infection and reinfection of Mpox virus (MPXV), as well as the factors affecting the effectiveness of Mpox vaccine are not characterized. Herein, a literature review was preformed to summarize the risk factors and important clinical symptoms of patients with Mpox breakthrough infection or reinfection, as well as the factors affecting the effectiveness of smallpox vaccine against Mpox. Results showed that MSM sexual behavior, condomless sexual behavior, multiple sexual partners, close contact, HIV infection, and the presence of comorbidity are important risk factors for Mpox breakthrough infection and reinfection. Genital ulcers, proctitis, and lymphadenopathy are the important clinical symptoms of Mpox breakthrough infection and reinfection. The effectiveness of emergent vaccination of smallpox vaccine for post-exposure of MPXV is associated with smallpox vaccination history, interval between exposure and vaccination, and history of HIV infection. This review provides a better understanding for the risk factors and important clinical symptoms of Mpox breakthrough infection and reinfection, as well as the formulation of Mpox vaccine vaccination strategies.
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Affiliation(s)
- Wenyi Jiang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Yibo Hu
- Department of Stomatology, School of Medicine, Nankai University, Tianjin, China
| | - Xiu Yang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Lingli Hou
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Jingjing Zhang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Hong Niu
- School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, China
| | - Congxia Hu
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Jihui Lin
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
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10
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Morino E, Mine S, Tomita N, Uemura Y, Shimizu Y, Saito S, Suzuki T, Okumura N, Iwasaki H, Terada J, Ainai A, Sakai Y, Park E, Seki S, Akazawa D, Shimojima M, Shiwa-Sudo N, Virhuez-Mendoza M, Miyauchi K, Moriyama S, Iwata-Yoshikawa N, Harada M, Harada S, Hishiki T, Kotaki R, Matsumura T, Miyamoto S, Kanno T, Isogawa M, Watashi K, Nagata N, Ebihara H, Takahashi Y, Maeda K, Matano T, Wakita T, Suzuki T, Sugiura W, Ohmagari N, Ujiie M. Mpox Neutralizing Antibody Response to LC16m8 Vaccine in Healthy Adults. NEJM EVIDENCE 2024; 3:EVIDoa2300290. [PMID: 38411447 DOI: 10.1056/evidoa2300290] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
BACKGROUND: Vaccination against mpox (formerly known as monkeypox), an infectious disease caused by the monkeypox virus (MPXV), is needed to prevent outbreaks and consequent public health concerns. The LC16m8 vaccine, a dried cell-cultured proliferative live attenuated vaccinia virus–based vaccine, was approved in Japan against smallpox and mpox. However, its immunogenicity and efficacy against MPXV have not been fully assessed. We assessed the safety and immunogenicity of LC16m8 against MPXV in healthy adults. METHODS: We conducted a single-arm study that included 50 participants who were followed up for 168 days postvaccination. The primary end point was the neutralizing antibody seroconversion rate against MPXVs, including the Zr599 and Liberia strains, on day 28. The secondary end points included the vaccine “take” (major cutaneous reaction) rate, neutralizing titer kinetics against MPXV and vaccinia virus (LC16m8) strains, and safety outcomes. RESULTS: Seroconversion rates on day 28 were 72% (36 of 50), 70% (35 of 50), and 88% (44 of 50) against the Zr599 strain, the Liberia strain, and LC16m8, respectively. On day 168, seroconversion rates decreased to 30% (15 of 50) against the Zr599 and Liberia strains and to 76% (38 of 50) against LC16m8. The vaccine “take” (broad definition) rate on day 14 was 94% (46 of 49). Adverse events (AEs), including common solicited cutaneous reactions, occurred in 98% (45 of 48) of participants; grade 3 severity AEs occurred in 16% (8 of 50). No deaths, serious AEs, or mpox onset incidences were observed up to day 168. CONCLUSIONS: The LC16m8 vaccine generated neutralizing antibody responses against MPXV in healthy adults. No serious safety concerns occurred with LC16m8 use. (Funded by the Ministry of Health, Labour and Welfare of Japan; Japan Registry of Clinical Trials number, jRCTs031220171.)
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Affiliation(s)
- Eriko Morino
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo
- Department Respiratory Medicine, National Center for Global Health and Medicine, Tokyo
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo
| | - Sohtaro Mine
- Department of Pathology, National Institute of Infectious Diseases, Tokyo
| | - Noriko Tomita
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo
| | - Yukari Uemura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo
| | - Yosuke Shimizu
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo
| | - Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo
| | - Nobumasa Okumura
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo
| | - Haruka Iwasaki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo
| | - Junko Terada
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo
- Department Respiratory Medicine, National Center for Global Health and Medicine, Tokyo
| | - Akira Ainai
- Department of Pathology, National Institute of Infectious Diseases, Tokyo
| | - Yusuke Sakai
- Department of Pathology, National Institute of Infectious Diseases, Tokyo
| | - Eunsil Park
- Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo
| | - Sayuri Seki
- AIDS Research Center, National Institute of Infectious Diseases, Tokyo
| | - Daisuke Akazawa
- Research Center for Drug and Vaccine Development, National Institute of Infectious Diseases, Tokyo
| | - Masayuki Shimojima
- Department of Virology I, National Institute of Infectious Diseases, Tokyo
| | - Nozomi Shiwa-Sudo
- Department of Pathology, National Institute of Infectious Diseases, Tokyo
| | | | - Kosuke Miyauchi
- AIDS Research Center, National Institute of Infectious Diseases, Tokyo
| | - Saya Moriyama
- Research Center for Drug and Vaccine Development, National Institute of Infectious Diseases, Tokyo
| | | | - Michiko Harada
- Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo
| | - Shigeyoshi Harada
- AIDS Research Center, National Institute of Infectious Diseases, Tokyo
| | - Takayuki Hishiki
- Research Center for Drug and Vaccine Development, National Institute of Infectious Diseases, Tokyo
| | - Ryutaro Kotaki
- Research Center for Drug and Vaccine Development, National Institute of Infectious Diseases, Tokyo
| | - Takayuki Matsumura
- Research Center for Drug and Vaccine Development, National Institute of Infectious Diseases, Tokyo
| | - Sho Miyamoto
- Department of Pathology, National Institute of Infectious Diseases, Tokyo
| | - Takayuki Kanno
- Department of Pathology, National Institute of Infectious Diseases, Tokyo
| | - Masanori Isogawa
- Research Center for Drug and Vaccine Development, National Institute of Infectious Diseases, Tokyo
| | - Koichi Watashi
- Research Center for Drug and Vaccine Development, National Institute of Infectious Diseases, Tokyo
| | - Noriyo Nagata
- Department of Pathology, National Institute of Infectious Diseases, Tokyo
| | - Hideki Ebihara
- Department of Virology I, National Institute of Infectious Diseases, Tokyo
| | - Yoshimasa Takahashi
- Research Center for Drug and Vaccine Development, National Institute of Infectious Diseases, Tokyo
| | - Ken Maeda
- Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo
| | - Tetsuro Matano
- AIDS Research Center, National Institute of Infectious Diseases, Tokyo
| | | | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, Tokyo
| | - Wataru Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo
| | - Mugen Ujiie
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo
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11
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Amer FA, Nofal HA, Gebriel MG, Bedawy AM, Allam AA, Khalil HES, Elahmady M, Nofal H, Saeed MA, Shaltout SW, Behiry A, Attia O, Bahgat SM, Ali AA, Ahmed FM, Abdelrahman AM, Hammad NM. Grasping knowledge, attitude, and perception towards monkeypox among healthcare workers and medical students: an Egyptian cross-sectional study. Front Cell Infect Microbiol 2024; 14:1339352. [PMID: 38410721 PMCID: PMC10895011 DOI: 10.3389/fcimb.2024.1339352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/24/2024] [Indexed: 02/28/2024] Open
Abstract
Background Monkeypox (Mpox) is a re-emerging infectious disease representing a new global challenge. It poses a substantial threat to countries, particularly those with a low number of cases. Due to its popularity as a tourist destination and its proximity to many African refugees, Egypt is potentially at risk of Mpox importation. Therefore, effective disease management necessitates healthcare workers (HCWs) to possess adept knowledge, along with a positive attitude and behavior. The study aimed to assess the knowledge, attitude, and perception of Egyptian HCWs and medical students towards human Mpox. Methods The present cross-sectional study data was collected from participants between October and December 2022 via a questionnaire. The questionnaire comprised 31 questions in the knowledge section, 11 questions in the attitude section, and 14 in the perception section. Results The present study involved a total of 1,034 HCWs and medical students. It was found that 55.3% of the participants demonstrated adequate knowledge about Mpox, whereas 44.5% and 39.8% of the respondents exhibited favorable attitudes and perceptions towards the disease, respectively. Binary logistic regression analysis revealed that adequate knowledge was significantly observed in ages older than 40 years (p < 0.001), married participants (p < 0.001), and doctors (p < 0.001). The positive attitude was significantly observed among the male sex (p = 0.045), urban residents (p = 0.002), and nurses (p = 0.002). Conversely, married participants (p = 0.013), doctors (p < 0.001), and individuals employed in pharmacy and laboratory departments (p < 0.001) experienced an increase in positive perception. Conclusion Knowledge, attitude, and perception towards Mpox among Egyptian HCWs and medical students exhibit suboptimal levels. Addressing these gaps is crucial to controlling and effectively preventing disease transmission.
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Affiliation(s)
- Fatma A. Amer
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- Viral Infection Working Group of International Society of Antimicrobial Chemotherapy (VIWG/ISAC), London, United Kingdom
| | - Hanaa A. Nofal
- Department of Public Health and Community Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Manar G. Gebriel
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Aya M. Bedawy
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ayman A. Allam
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hend E. S. Khalil
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- Microbiology and Immunology, Qatar Armed Forces Hospital, Doha, Qatar
| | - Mohammed Elahmady
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- Microbiology, Al Ahli Hospital, Doha, Qatar
| | - Hagar Nofal
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Maysaa A. Saeed
- Viral Infection Working Group of International Society of Antimicrobial Chemotherapy (VIWG/ISAC), London, United Kingdom
- Department of Tropical Medicine, Zagazig University, Zagazig, Egypt
| | | | - Ahmed Behiry
- Department of Tropical Medicine, Zagazig University, Zagazig, Egypt
| | - Osama Attia
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Ahmed A. Ali
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Fatma Mohammed Ahmed
- Department of Community Health Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt
| | | | - Noha M. Hammad
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- Viral Infection Working Group of International Society of Antimicrobial Chemotherapy (VIWG/ISAC), London, United Kingdom
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12
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Hazra A, Zucker J, Bell E, Flores J, Gordon L, Mitjà O, Suñer C, Lemaignen A, Jamard S, Nozza S, Nori AV, Pérez-Barragán E, Rodríguez-Aldama JC, Blanco JL, Delaugerre C, Turner D, Fuertes I, Leiro V, Walmsley SL, Orkin CM. Mpox in people with past infection or a complete vaccination course: a global case series. THE LANCET. INFECTIOUS DISEASES 2024; 24:57-64. [PMID: 37678309 DOI: 10.1016/s1473-3099(23)00492-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/13/2023] [Accepted: 07/25/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Since May, 2022, a large global outbreak of human mpox (formerly known as monkeypox) has predominantly affected men who have sex with men. The strain responsible, Clade IIb, has mutated substantially from precursors originating from the 2017-18 outbreak in Nigeria. Immunity to smallpox, another orthopoxvirus, via previous infection or vaccination provides lifelong immunity. However, since the 2022 mpox outbreak, recent clusters were described in individuals with presumed immunity through recent infection or vaccination. We aim to describe the epidemiological and clinical characteristics of mpox in individuals with past infection or vaccination to improve the understanding of this disease in the setting of previous immunity. METHODS In this global case series, international collaborators from nine countries provided data on individuals with PCR-confirmed mpox after documented previous infection or vaccination between May 11, 2022, and June 30, 2023. We excluded cases that could not confirm vaccination status or cases with partial immunisation or any doses received before the current multi-national mpox outbreak (cutoff date May 1, 2022). Data were collected via a case report spreadsheet that reported on dates of infection and vaccination, route of immunisation, demographic characteristics, clinical findings, HIV status, concomitant sexually transmitted infections, and markers of disease severity (mpox severity score system). We describe case epidemiology, clinical course, and mpox severity scores; all analyses were descriptive. FINDINGS We report mpox infections in 37 gay and bisexual men who have sex with men: seven individuals had mpox reinfections, 29 individuals had mpox infections that occurred after two appropriately spaced Modified Vaccinia Ankara-Bavarian Nordic vaccine courses, and one individual had an infection that met the criteria for both reinfection and infection after vaccination. The median age of individuals was 36 years (IQR 30-45; range 21-58). Those with natural immunity after initial infection had a shorter disease course with less mucosal disease upon reinfection than with their initial infection. Infections post-vaccination were characterised by few lesions, little mucosal disease, and minimal analgesia requirements; two people received oral tecovirimat. Overall, there were no deaths, no bacterial superinfections, and all individuals were managed in the ambulatory clinic with one hospital admission for a necrotising neck lesion. INTERPRETATION The epidemiology of people with mpox reinfection or infection post-vaccination was similar to other published cohorts during the 2022 outbreak-predominantly young, sexually active gay and bisexual men who have sex with men. Clinical features and outcomes of repeat infection and infection after vaccination appear to be less clinically severe than those described in 2022 case literature. Specifically, compared with the 2022 case series, these individuals in the present study had fewer confluent lesions, less mucosal involvement, reduced analgesia requirement, and fewer admissions. Natural immunity and vaccine-induced immunity are not fully protective against mpox infection. However, in this small series both disease duration and severity appear to be reduced. FUNDING None.
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Affiliation(s)
- Aniruddha Hazra
- Section of Infectious Diseases and Global Health, University of Chicago Medicine, Chicago, IL, USA; Howard Brown Health, Chicago, IL, USA
| | - Jason Zucker
- Division of Infectious Diseases, Columbia University Irving Medical Center, New York, NY, USA
| | - Elizabeth Bell
- Section of Infectious Diseases and Global Health, University of Chicago Medicine, Chicago, IL, USA
| | - John Flores
- Section of Infectious Diseases and Global Health, University of Chicago Medicine, Chicago, IL, USA
| | | | - Oriol Mitjà
- Skin Neglected Tropical Diseases and Sexually Transmitted Infections section, Fight Infectious Diseases Foundation, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Clara Suñer
- Skin Neglected Tropical Diseases and Sexually Transmitted Infections section, Fight Infectious Diseases Foundation, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Adrien Lemaignen
- Department of Infectious Diseases, University Hospital of Tours, Tours, France
| | - Simon Jamard
- Department of Infectious Diseases, University Hospital of Tours, Tours, France
| | - Silvia Nozza
- Vita-Salute San Raffaele University, Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | - Jose Louis Blanco
- Infectious Diseases Department, Hospital Clínic de Barcelona, Barcelona University, Barcelona, Spain
| | - Constance Delaugerre
- Service de Virologie, Hôpital Saint-Louis, AP-HP, Université Paris Cité, Paris, France
| | - Dan Turner
- Crusaid Kobler AIDS Center, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Irene Fuertes
- Dermatology Department, Hospital Clinic, Barcelona, Spain
| | - Viviana Leiro
- Dermatology Department, Hospital Muñiz, Buenos Aires, Argentina
| | - Sharon L Walmsley
- University Health Network, University of Toronto, Toronto, ON, Canada
| | - Chloe M Orkin
- Blizard Institute and SHARE Collaborative, Queen Mary University of London, London, UK; Department of Infection and Immunity, Barts Health NHS Trust, London, UK.
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13
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Grabenstein JD, Hacker A. Vaccines against mpox: MVA-BN and LC16m8. Expert Rev Vaccines 2024; 23:796-811. [PMID: 39188013 DOI: 10.1080/14760584.2024.2397006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 08/08/2024] [Accepted: 08/22/2024] [Indexed: 08/28/2024]
Abstract
INTRODUCTION Global outbreaks involving mpox clade IIb began in mid-2022. Today, clade IIb and clade I outbreaks continue. Reliable mpox vaccines can prevent serious mpox disease and death. AREAS COVERED Globally, two vaccines hold mpox indications, regardless of mpox viral clade: MVA-BN (Bavarian Nordic) and LC16m8 (KM Biologics). This review summarizes the human and pivotal animal data establishing safety and efficacy for MVA-BN and LC16m8, including real-world evidence gathered during mpox outbreaks from 2022 through 2024. EXPERT OPINION Some regulatory decisions for MVA-BN and LC16m8 followed pathways based on surrogate outcomes, including lethal-challenge studies in nonhuman primates, among other atypical aspects. Nonetheless, MVA-BN and LC16m8 hold unencumbered registration in multiple countries. Effectiveness of MVA-BN as primary preventive vaccination (PPV) in humans against clade IIb mpox is clear from real-world studies; effectiveness of LC16m8 against clade IIb is likely from surrogate endpoints. Effectiveness of MVA-BN and LC16m8 as PPV against more-lethal clade I is likely, based on animal-challenge studies with multiple orthopoxvirus species and other studies. Both vaccines have solid safety records. MVA-BN's replication incompetence favors adoption, whereas LC16m8 has more pediatric data. Additional real-world evidence, in additional geographic settings and special populations (e.g. pregnancy, immune suppression, atopic dermatitis), is needed.
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Affiliation(s)
| | - Adam Hacker
- Coalition for Epidemic Preparedness & Innovation, Oslo, Norway
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14
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Speiser LJ, Wonnaparhown AM, Blair J, Shah A, Patel DR, McCullough AE, Nicolasora N, Khalsa AM, Orenstein R, Vikram HR, Huang V, Seville MT. A Case of Sustained Viral Shedding of Mpox With Ocular Involvement Resulting in Vision Loss. Open Forum Infect Dis 2024; 11:ofad632. [PMID: 38264094 PMCID: PMC10805344 DOI: 10.1093/ofid/ofad632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/11/2023] [Indexed: 01/25/2024] Open
Abstract
Mpox, caused by infection with Monkeypox virus, usually presents as a mild, self-limited illness in immunocompetent persons that resolves within 2-4 weeks. Serious complications have been reported when mpox lesions involve vulnerable anatomic sites, such as the eye, and in those with substantial immunosuppression. We describe a patient with advanced human immunodeficiency virus infection and sustained viral shedding of mpox with ocular involvement, which resulted in vision loss.
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Affiliation(s)
- Lisa J Speiser
- Department of Medicine, Division of Infectious Diseases, The Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Alex M Wonnaparhown
- Department of Medicine, Division of Allergy and Immunology, The Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Janis Blair
- Department of Medicine, Division of Infectious Diseases, The Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Ami Shah
- Department of Ophthalmology, The Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Dharmendra R Patel
- Department of Ophthalmology, The Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Ann E McCullough
- Department of Laboratory Medicine and Pathology, Division of Anatomic Pathology, The Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Nelson Nicolasora
- Department of Medicine, Banner University Medical Center, Phoenix, Arizona, USA
| | - Ann M Khalsa
- Department of Family Medicine, Valleywise Health Medical Center, Phoenix, Arizona, USA
| | - Robert Orenstein
- Department of Medicine, Division of Infectious Diseases, The Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Holenarasipur R Vikram
- Department of Medicine, Division of Infectious Diseases, The Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Vivian Huang
- Maricopa County Department of Public Health, Division of Epidemiology and Public Health Informatics, Phoenix, Arizona, USA
- Department of Medical Affairs, Novavax Inc., Gaithersburg, Maryland, USA
| | - Maria Teresa Seville
- Department of Medicine, Division of Infectious Diseases, The Mayo Clinic Arizona, Phoenix, Arizona, USA
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15
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Cornelisse VJ, Kearley JJM, Vargas Castillo J, Macharg L, McLaughlin VA, Jack SJ, Swift C. Case study: breakthrough mpox infection in Aotearoa New Zealand and Australia after completed two-dose course of subcutaneous modified vaccinia Ankara (MVA-BN) vaccines. Sex Health 2023; 20:585-587. [PMID: 37852607 DOI: 10.1071/sh23139] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND In August 2022, in response to a global mpox outbreak, the World Health Organization recommended the Vaccinia vaccination for at-risk people. METHODS Case study. RESULTS We describe a case of a HIV-negative bisexual man who developed a symptomatic mpox infection 13weeks after completing a two-dose course of subcutaneous third-generation modified vaccinia Ankara vaccines. The case likely acquired his mpox infection in the USA; was diagnosed in Aotearoa, New Zealand; and was followed-up in Australia, as he was actively travelling during his infection. CONCLUSIONS This case highlights the importance of maintaining clinical suspicion for mpox in people who present with consistent symptoms, even if they are fully vaccinated. Also, as he travelled around Aotearoa, New Zealand, and Australia during his infection, this case highlights how public health authorities and clinicians can cooperate across jurisdictional boundaries to support cases and minimise the risk of onward transmission.
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Affiliation(s)
- Vincent J Cornelisse
- Kirketon Road Centre, NSW Health, Sydney, NSW, Australia; and The Kirby Institute, University of NSW, Sydney, NSW, Australia; and Monash University, Melbourne, Vic., Australia
| | | | | | - Lindsay Macharg
- Queenstown Medical Centre, Queenstown, Aotearoa, New Zealand
| | | | - Susan J Jack
- Te Whatu Ora Southern, National Public Health Service, Aotearoa, New Zealand
| | - Caitlin Swift
- Public Health Unit, South Eastern Sydney Local Health District, Sydney, NSW, Australia
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16
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Desai AN, Malani PN. Mpox and the importance of clinical history and physical examination. Clin Microbiol Infect 2023; 29:1480-1481. [PMID: 37678510 DOI: 10.1016/j.cmi.2023.08.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/09/2023]
Affiliation(s)
- Angel N Desai
- Division of Infectious Diseases, University of California Davis, Sacramento, CA, USA
| | - Preeti N Malani
- Division of Infectious Diseases, University of Michigan, Ann Arbor, MI, USA.
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17
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Zucker J, Hazra A, Titanji BK. Mpox and HIV-Collision of Two Diseases. Curr HIV/AIDS Rep 2023; 20:440-450. [PMID: 37994953 DOI: 10.1007/s11904-023-00682-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
PURPOSE OF REVIEW The global outbreak of mpox has brought renewed attention to a previously neglected disease which is particularly severe in people with underlying untreated HIV co-infection. For this population, the disease is progressive, severe, and often lethal. In this review, we examine the pathogenesis of mpox disease and its collision with co-existent HIV infection and discuss key considerations for management as well as emerging clinical dilemmas and areas for future research. RECENT FINDINGS Co-existent untreated HIV infection characterized by severe immunocompromise potentiates the nefarious effects of monkeypox virus infection leading to severe manifestations of mpox. Treating mpox in the context of HIV requires mpox-directed therapies, supportive care, and HIV-specific treatment to restore immune function. Preventative measures for PWH are like those in healthy individuals, but the effectiveness and durability of protection conferred by existing vaccines in PWH remain to be fully characterized. Mpox is an important opportunistic infection in PWH. Clinicians should be aware of the unique features of the disease in this population and approaches to care and management of mpox in PWH.
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Affiliation(s)
- Jason Zucker
- Department of Infectious Diseases, Columbia University, New York, NY, USA
| | - Aniruddha Hazra
- Section of Infectious Diseases and Global Health, University of Chicago Medicine, Chicago, IL, USA
| | - Boghuma K Titanji
- Division of Infectious Diseases, Health Sciences Research Building I, Emory University School of Medicine, 1760 Haygood Drive NE, W300, Rm 327, Atlanta, GA, USA.
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18
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Ghazy RM, Elrewany E, Gebreal A, ElMakhzangy R, Fadl N, Elbanna EH, Tolba MM, Hammad EM, Youssef N, Abosheaishaa H, Hamouda EEM, Mehana ZEE, Al Zomia AS, A Alnami RA, Salma EAS, Alqahtani AS, Alshehri AF, Hussein M. Systematic Review on the Efficacy, Effectiveness, Safety, and Immunogenicity of Monkeypox Vaccine. Vaccines (Basel) 2023; 11:1708. [PMID: 38006040 PMCID: PMC10674429 DOI: 10.3390/vaccines11111708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The variation in the reported vaccine safety and effectiveness could contribute to the high rates of vaccine hesitancy among the general population and healthcare workers in areas where monkeypox (mpox) is circulating. In this review, our objective was to evaluate the safety, immunogenicity, effectiveness, and efficacy of the mpox vaccines. METHODS An extensive search for articles across multiple databases was performed, including searching six databases (PubMed Central, PubMed Medline, Scopus, Web of Science, Cochrane, ProQuest), two pre-print databases (European PMC Preprint and MedRxiv), and Google Scholar. RESULTS A total of 4290 citations were retrieved from the included databases. Following the removal of duplicates and the initial screening of records, a total of 36 studies were included into the analysis. Additionally, we identified five more studies through manual searches, resulting in a total of 41 eligible articles for qualitative synthesis. The study findings revealed that mpox vaccines demonstrate the ability to generate adequate antibodies; however, their effectiveness may decrease over time, exhibiting varying safety profiles. Most of the included studies consistently reported substantial levels of effectiveness and efficacy against mpox. Interestingly, the number of vaccine doses administered was found to influence the degree of immunogenicity, subsequently impacting the overall effectiveness and efficacy of the vaccines. Furthermore, we found that smallpox vaccines exhibited a form of cross-protection against mpox. CONCLUSIONS Vaccines can be used to prevent mpox and effectively control its spread.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt; (R.M.G.); (E.E.)
| | - Ehab Elrewany
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt; (R.M.G.); (E.E.)
| | - Assem Gebreal
- Alexandria Faculty of Medicine, Alexandria University, Alexandria 21561, Egypt; (A.G.); (E.M.H.); (Z.E.E.M.)
| | - Rony ElMakhzangy
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt; (R.E.); (N.F.)
| | - Noha Fadl
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt; (R.E.); (N.F.)
| | - Eman Hassan Elbanna
- Health Administration and Behavioral Sciences Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt;
| | - Mahmoud M. Tolba
- Pharmaceutical Division, Ministry of Health and Population, Faiyum City 63723, Egypt;
| | - Elsayed Mohamed Hammad
- Alexandria Faculty of Medicine, Alexandria University, Alexandria 21561, Egypt; (A.G.); (E.M.H.); (Z.E.E.M.)
| | - Naglaa Youssef
- Medical-Surgical Nursing, Faculty of Nursing, Cairo University, Cairo 11562, Egypt;
| | | | | | - Zeyad Elsayed Eldeeb Mehana
- Alexandria Faculty of Medicine, Alexandria University, Alexandria 21561, Egypt; (A.G.); (E.M.H.); (Z.E.E.M.)
| | - Ahmed Saad Al Zomia
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Raad Ahmed A Alnami
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Emad Ali Saeed Salma
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Abdulaziz Saleh Alqahtani
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Abdulaziz Fayez Alshehri
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Mai Hussein
- Clinical Research Administration, Alexandria Directorate of Health Affairs, Alexandria 21561, Egypt
- Egyptian Ministry of Health and Population, Cairo 11562, Egypt
- Master of Medical Science in Clinical Investigation, Harvard Medical School, Boston, MA 02115, USA
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19
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Taha AM, Rodriguez-Morales AJ, Sah R. Mpox breakthrough infections: concerns and actions. THE LANCET. INFECTIOUS DISEASES 2023; 23:1216-1218. [PMID: 37689079 DOI: 10.1016/s1473-3099(23)00546-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/11/2023]
Affiliation(s)
- Amira Mohamed Taha
- Faculty of Medicine, Fayoum University, Fayoum, Egypt; Medical Research Group of Egypt (MRGE), Negida Academy, Arlington, MA, USA
| | - Alfonso J Rodriguez-Morales
- Clinical Epidemiology and Biostatistics Program, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru; Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Ranjit Sah
- Department of Microbiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu 44600, Nepal; Department of Microbiology, Dr DY Patil Medical College, Hospital and Research Centre, Dr DY Patil Vidyapeeth, Pune, India; Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, India.
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20
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Freyn AW, Atyeo C, Earl PL, Americo JL, Chuang GY, Natarajan H, Frey TR, Gall JG, Moliva JI, Hunegnaw R, Asthagiri Arunkumar G, Ogega CO, Nasir A, Santos G, Levin RH, Meni A, Jorquera PA, Bennett H, Johnson JA, Durney MA, Stewart-Jones G, Hooper JW, Colpitts TM, Alter G, Sullivan NJ, Carfi A, Moss B. An mpox virus mRNA-lipid nanoparticle vaccine confers protection against lethal orthopoxviral challenge. Sci Transl Med 2023; 15:eadg3540. [PMID: 37792954 DOI: 10.1126/scitranslmed.adg3540] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 08/18/2023] [Indexed: 10/06/2023]
Abstract
Mpox virus (MPXV) caused a global outbreak in 2022. Although smallpox vaccines were rapidly deployed to curb spread and disease among those at highest risk, breakthrough disease was noted after complete immunization. Given the threat of additional zoonotic events and the virus's evolving ability to drive human-to-human transmission, there is an urgent need for an MPXV-specific vaccine that confers protection against evolving MPXV strains and related orthopoxviruses. Here, we demonstrate that an mRNA-lipid nanoparticle vaccine encoding a set of four highly conserved MPXV surface proteins involved in virus attachment, entry, and transmission can induce MPXV-specific immunity and heterologous protection against a lethal vaccinia virus (VACV) challenge. Compared with modified vaccinia virus Ankara (MVA), which forms the basis for the current MPXV vaccine, immunization with an mRNA-based MPXV vaccine generated superior neutralizing activity against MPXV and VACV and more efficiently inhibited spread between cells. We also observed greater Fc effector TH1-biased humoral immunity to the four MPXV antigens encoded by the vaccine, as well as to the four VACV homologs. Single MPXV antigen-encoding mRNA vaccines provided partial protection against VACV challenge, whereas multivalent vaccines combining mRNAs encoding two, three, or four MPXV antigens protected against disease-related weight loss and death equal or superior to MVA vaccination. These data demonstrate that an mRNA-based MPXV vaccine confers robust protection against VACV.
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Affiliation(s)
| | | | - Patricia L Earl
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, 20892 MD, USA
| | - Jeffrey L Americo
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, 20892 MD, USA
| | | | | | | | - Jason G Gall
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, 20892 MD, USA
| | - Juan I Moliva
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, 20892 MD, USA
| | - Ruth Hunegnaw
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, 20892 MD, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Jay W Hooper
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, 21702 MD, USA
| | | | | | - Nancy J Sullivan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, 20892 MD, USA
| | | | - Bernard Moss
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, 20892 MD, USA
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21
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Zhang N, Cheng X, Zhu Y, Mo O, Yu H, Zhu L, Zhang J, Kuang L, Gao Y, Cao R, Liang X, Wang H, Li H, Li S, Zhong W, Li X, Li X, Hao P. Multi-valent mRNA vaccines against monkeypox enveloped or mature viron surface antigens demonstrate robust immune response and neutralizing activity. SCIENCE CHINA. LIFE SCIENCES 2023; 66:2329-2341. [PMID: 37300753 PMCID: PMC10257374 DOI: 10.1007/s11427-023-2378-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023]
Abstract
Monkeypox was declared a global health emergency by the World Health Organization, and as of March 2023, 86,000 confirmed cases and 111 deaths across 110 countries have been reported. Its causal agent, monkeypox virus (MPV) belongs to a large family of double-stranded DNA viruses, Orthopoxviridae, that also includes vaccinia virus (VACV) and others. MPV produces two distinct forms of viral particles during its replication cycles: the enveloped viron (EV) that is released via exocytosis, and the mature viron (MV) that is discharged through lysis of host cells. This study was designed to develop multi-valent mRNA vaccines against monkeypox EV and MV surface proteins, and examine their efficacy and mechanism of action. Four mRNA vaccines were produced with different combinations of surface proteins from EV (A35R and B6R), MV (A29L, E8L, H3L and M1R), or EV and MV, and were administered in Balb/c mice to assess their immunogenicity potentials. A dynamic immune response was observed as soon as seven days after initial immunization, while a strong IgG response to all immunogens was detected with ELISA after two vaccinations. The higher number of immunogens contributed to a more robust total IgG response and correlating neutralizing activity against VACV, indicating the additive potential of each immunogen in generating immune response and nullifying VACV infection. Further, the mRNA vaccines elicited an antigen-specific CD4+ T cell response that is biased towards Th1. The mRNA vaccines with different combinations of EV and MV surface antigens protected a mouse model from a lethal dose VACV challenge, with the EV and MV antigens-combined vaccine offering the strongest protection. These findings provide insight into the protective mechanism of multi-valent mRNA vaccines against MPV, and also the foundation for further development of effective and safe mRNA vaccines for enhanced protection against monkeypox virus outbreak.
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Affiliation(s)
- Niubing Zhang
- Key Laboratory of Synthetic Biology, CAS Center for Excellence in Molecular Plant Sciences, Institute of Plant Physiology and Ecology, Chinese Academy of Sciences, Shanghai, 200032, China
- East China University of Science and Technology, Shanghai, 200237, China
- Lingang Laboratory, Shanghai, 200031, China
| | - Xiang Cheng
- Key Laboratory of Synthetic Biology, CAS Center for Excellence in Molecular Plant Sciences, Institute of Plant Physiology and Ecology, Chinese Academy of Sciences, Shanghai, 200032, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yilong Zhu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, 130122, China
- Academicians Workstation of Jilin Province, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Ouyang Mo
- Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Huiqing Yu
- Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Liqi Zhu
- Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Juan Zhang
- Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Linlin Kuang
- Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Ying Gao
- Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Ruiyuan Cao
- National Engineering Research Center for the Emergency Drug, Beijing Institute of Pharmacology and Toxicology, Beijing, 100850, China
| | - Xiaozhen Liang
- Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Haikun Wang
- Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Honglin Li
- East China University of Science and Technology, Shanghai, 200237, China
- Lingang Laboratory, Shanghai, 200031, China
| | - Song Li
- National Engineering Research Center for the Emergency Drug, Beijing Institute of Pharmacology and Toxicology, Beijing, 100850, China
| | - Wu Zhong
- National Engineering Research Center for the Emergency Drug, Beijing Institute of Pharmacology and Toxicology, Beijing, 100850, China.
| | - Xuan Li
- Key Laboratory of Synthetic Biology, CAS Center for Excellence in Molecular Plant Sciences, Institute of Plant Physiology and Ecology, Chinese Academy of Sciences, Shanghai, 200032, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Xiao Li
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, 130122, China.
| | - Pei Hao
- Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
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22
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Wang Y, Yang K, Zhou H. Immunogenic proteins and potential delivery platforms for mpox virus vaccine development: A rapid review. Int J Biol Macromol 2023:125515. [PMID: 37353117 PMCID: PMC10284459 DOI: 10.1016/j.ijbiomac.2023.125515] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/15/2023] [Accepted: 06/20/2023] [Indexed: 06/25/2023]
Abstract
Since May 2022, the mpox virus (MPXV) has spread worldwide and become a potential threat to global public health. Vaccines are important tools for preventing MPXV transmission and infection in the population. However, there are still no available potent and applicable vaccines specifically for MPXV. Herein, we highlight several potential vaccine targets for MPVX and emphasize potent immunogens, such as M1R, E8L, H3L, A29L, A35R, and B6R proteins. These proteins can be integrated into diverse vaccine platforms to elicit powerful B-cell and T-cell responses, thereby providing protective immunity against MPXV infection. Overall, research on the MPXV vaccine targets would provide valuable information for developing timely effective MPXV-specific vaccines.
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Affiliation(s)
- Yang Wang
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu 610000, China
| | - Kaiwen Yang
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu 610000, China
| | - Hao Zhou
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu 610000, China.
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23
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Lee B, Nanishi E, Levy O, Dowling DJ. Precision Vaccinology Approaches for the Development of Adjuvanted Vaccines Targeted to Distinct Vulnerable Populations. Pharmaceutics 2023; 15:1766. [PMID: 37376214 PMCID: PMC10305121 DOI: 10.3390/pharmaceutics15061766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Infection persists as one of the leading global causes of morbidity and mortality, with particular burden at the extremes of age and in populations who are immunocompromised or suffer chronic co-morbid diseases. By focusing discovery and innovation efforts to better understand the phenotypic and mechanistic differences in the immune systems of diverse vulnerable populations, emerging research in precision vaccine discovery and development has explored how to optimize immunizations across the lifespan. Here, we focus on two key elements of precision vaccinology, as applied to epidemic/pandemic response and preparedness, including (a) selecting robust combinations of adjuvants and antigens, and (b) coupling these platforms with appropriate formulation systems. In this context, several considerations exist, including the intended goals of immunization (e.g., achieving immunogenicity versus lessening transmission), reducing the likelihood of adverse reactogenicity, and optimizing the route of administration. Each of these considerations is accompanied by several key challenges. On-going innovation in precision vaccinology will expand and target the arsenal of vaccine components for protection of vulnerable populations.
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Affiliation(s)
- Branden Lee
- Precision Vaccines Program, Boston Children’s Hospital, Boston, MA 02115, USA; (B.L.); (E.N.); (O.L.)
| | - Etsuro Nanishi
- Precision Vaccines Program, Boston Children’s Hospital, Boston, MA 02115, USA; (B.L.); (E.N.); (O.L.)
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Ofer Levy
- Precision Vaccines Program, Boston Children’s Hospital, Boston, MA 02115, USA; (B.L.); (E.N.); (O.L.)
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - David J. Dowling
- Precision Vaccines Program, Boston Children’s Hospital, Boston, MA 02115, USA; (B.L.); (E.N.); (O.L.)
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
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24
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Shamim MA, Satapathy P, Padhi BK, Veeramachaneni SD, Akhtar N, Pradhan A, Agrawal A, Dwivedi P, Mohanty A, Pradhan KB, Kabir R, Rabaan AA, Alotaibi J, Al Ismail ZA, Alsoliabi ZA, Al Fraij A, Sah R, Rodriguez-Morales AJ. Pharmacological treatment and vaccines in monkeypox virus: a narrative review and bibliometric analysis. Front Pharmacol 2023; 14:1149909. [PMID: 37214444 PMCID: PMC10196034 DOI: 10.3389/fphar.2023.1149909] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/25/2023] [Indexed: 05/24/2023] Open
Abstract
Mpox (earlier known as monkeypox) virus infection is a recognized public health emergency. There has been little research on the treatment options. This article reviews the specific drugs used to treat mpox virus infection and the vaccines used here. Instead of focusing on the mechanistic basis, this review narrates the practical, real-life experiences of individual patients of mpox virus disease being administered these medicines. We conducted a bibliometric analysis on the treatment of the mpox virus using data from several databases like PubMed, Scopus, and Embase. The research on this topic has grown tremendously recently but it is highly concentrated in a few countries. Cidofovir is the most studied drug. This is because it is indicated and also used off-label for several conditions. The drugs used for mpox virus infection include tecovirimat, cidofovir, brincidofovir, vaccinia immune globulin, and trifluridine. Tecovirimat is used most frequently. It is a promising option in progressive mpox disease in terms of both efficacy and safety. Brincidofovir has been associated with treatment discontinuation due to elevated hepatic enzymes. Cidofovir is also not the preferred drug, often used because of the unavailability of tecovirimat. Trifluridine is used topically as an add-on agent along with tecovirimat for ocular manifestations of mpox virus disease. No study reports individual patient data for vaccinia immune globulin. Though no vaccine is currently approved for mpox virus infection, ACAM 2000 and JYNNEOS are the vaccines being mainly considered. ACAM 2000 is capable of replicating and may cause severe adverse reactions. It is used when JYNNEOS is contraindicated. Several drugs and vaccines are under development and have been discussed alongside pragmatic aspects of mpox virus treatment and prevention. Further studies can provide more insight into the safety and efficacy of Tecovirimat in actively progressing mpox virus disease.
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Affiliation(s)
| | - Prakisini Satapathy
- Department of Virology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bijaya Kumar Padhi
- Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Naushaba Akhtar
- Indian Council of Medical Research—Regional Medical Research Centre, Bhubaneswar, India
| | - Anindita Pradhan
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India
| | - Abhimanyu Agrawal
- Department of Pharmacology, All India Institute of Medical Sciences, Bathinda, India
| | - Pradeep Dwivedi
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India
- Centre of Excellence for Tribal Health, All India Institute of Medical Sciences, Jodhpur, India
| | - Aroop Mohanty
- All India Institute of Medical Sciences, Gorakhpur, India
| | | | - Russell Kabir
- School of Allied Health, Anglia Ruskin University, Essex, United Kingdom
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Jawaher Alotaibi
- Infectious Diseases Unit, King Faisal Specialist Hospital and Research Center, Department of Medicine, Riyadh, Saudi Arabia
| | - Zainab A. Al Ismail
- Long Term Care Department, Dhahran Long Term Hospital, Dhahran, Saudi Arabia
| | | | - Ali Al Fraij
- Medical Laboratories and Blood Bank Department, Jubail Health Network, Jubail, Saudi Arabia
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
- Harvard Medical School, Boston, MA, United States
- Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Alfonso J. Rodriguez-Morales
- Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
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Starks TJ, Scales D, Castiblanco J, Gorman J, Cain D. Correlates of Mpox Vaccination among Sexual Minority Men in the United States: Sexual Behavior, Substance Use, and Main Partner Relationships. JOURNAL OF SEX RESEARCH 2023; 60:634-644. [PMID: 36920105 PMCID: PMC10175215 DOI: 10.1080/00224499.2023.2188443] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Sexual minority men (SMM) have accounted for the majority of infections during the 2022 outbreak of the orthopox virus known as mpox (previously "monkeypox") in the US. This study examined correlates of mpox vaccination. Between July 28 and September 22, 2022, adult cisgender SMM (n = 2,620) not previously diagnosed with mpox responded to recruitment advertisements on social networking applications and completed an online survey. Of these, 730 (27.9%) received at least one vaccine dose. Logistic regression indicated sex with a casual partner was positively associated with vaccination. Stimulant drug use was negatively associated with vaccination; meanwhile, the use of ecstasy, ketamine, gamma-hydroxybutyrate (GHB) or psychedelics was positively associated with vaccination. Among partnered SMM, non-monogamous sexual agreements, relationship length of ≥2 years, and relationship functioning were positively associated with vaccination. Even at low levels of relationship functioning, SMM in non-monogamous relationships of ≥2 years were more likely to be vaccinated than single SMM. At very high levels of relationship functioning, partnered SMM were more likely to be vaccinated than single SMM regardless of sexual agreement or relationship length. Findings are discussed in relation to prior research on HIV, other STI prevention, and theories of dyadic functioning and health in this population.
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Affiliation(s)
- Tyrel J. Starks
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Doctoral Program in Health Psychology and Clinical Science, Graduate Center of CUNY, New York, NY, USA
| | - David Scales
- Division of General Internal Medicine, Weill Cornell Medicine, New York, NY, USA
- Critica, The Bronx, NY, USA
| | - Juan Castiblanco
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | | | - Demetria Cain
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
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26
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Pettit NN, Imam S, Sherer R, Hazra A. Treatment options for severe or refractory mpox virus infection in patients with advanced HIV. Int J STD AIDS 2023; 34:366-373. [PMID: 36708269 DOI: 10.1177/09564624231152940] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The Centers for Disease Control and Prevention (CDC) published a health advisory on the occurrence of severe cases of mpox in immunocompromised patients, namely those with advanced HIV. Treatment options are limited, and very little is known about how to optimally treat patients with severe disease. Herein we describe two cases of severe mpox in Chicago in the setting of advanced HIV and provide suggested guidance for managing cases of severe disease in immunocompromised patients based available data, CDC recommendations, and our experience managing these patients.
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Affiliation(s)
- Natasha N Pettit
- Department of Pharmacy, University of Chicago Medicine, Chicago, IL, USA
| | - Sabrina Imam
- Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Renslow Sherer
- Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Aniruddha Hazra
- Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
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27
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Evaluating the Immunogenicity and Safety of a Smallpox Vaccine to Monkeypox in Healthy Japanese Adults: A Single-Arm Study. Life (Basel) 2023; 13:life13030787. [PMID: 36983942 PMCID: PMC10059741 DOI: 10.3390/life13030787] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/28/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023] Open
Abstract
Monkeypox (mpox) is an acute exanthematous disease caused by the monkeypox virus (MPXV). Since May 2022, patients with mpox have been reported worldwide, mainly in Europe and the Americas. In Japan, LC16”KMB,” which is a smallpox vaccine derived from a dried cell culture, against mpox, has been approved. Although inoculation with a smallpox vaccine has been recommended to prevent MPXV infection, the immunogenicity of the smallpox vaccine against the MPXV is unclear, and information regarding postvaccination safety is scarce. We present the protocol for a single-arm open-label study to investigate the immunogenicity and safety of LC16”KMB” against the MPXV in healthy Japanese adults. The primary endpoint is the seroconversion rate of neutralizing antibodies against the MPXV on postvaccination day 28. The secondary endpoints are the seroconversion rates against the MPXV on postvaccination days 14 and 168; the seroconversion rates against the vaccinia virus on postvaccination days 14, 28, and 168; the incidence of mpox until day 168; and adverse and serious adverse events until postvaccination days 28 and 168. These results will pave the way for larger comparative studies using other smallpox vaccines to evaluate the test vaccine’s safety and efficacy in preventing mpox.
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28
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Stewart A, Schlebusch S, Vlack S, McMahon J, Sullivan M, Pyke A, Hajkowicz K. First case of mpox diagnosed in Queensland, Australia: clinical and molecular aspects. Med J Aust 2023; 218:157-159. [PMID: 36739109 DOI: 10.5694/mja2.51842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 02/06/2023]
Affiliation(s)
- Adam Stewart
- Centre for Clinical Research, University of Queensland, Brisbane, QLD.,Pathology Queensland, Brisbane, QLD
| | - Sanmarie Schlebusch
- Centre for Clinical Research, University of Queensland, Brisbane, QLD.,Queensland Public Health and Infectious Diseases Reference Genomics, Public and Environmental Health, Forensic and Scientific Services, Queensland, Health Brisbane, QLD
| | - Susan Vlack
- Metro North Hospital and Health Service, Brisbane, QLD.,University of Queensland, Brisbane, QLD
| | - Jamie McMahon
- Queensland Public Health and Infectious Diseases Reference Genomics, Public and Environmental Health, Forensic and Scientific Services, Queensland, Health Brisbane, QLD
| | - Mitchell Sullivan
- Queensland Public Health and Infectious Diseases Reference Genomics, Public and Environmental Health, Forensic and Scientific Services, Queensland, Health Brisbane, QLD
| | - Alyssa Pyke
- Queensland Public Health and Infectious Diseases Reference Genomics, Public and Environmental Health, Forensic and Scientific Services, Queensland, Health Brisbane, QLD
| | - Krispin Hajkowicz
- Centre for Clinical Research, University of Queensland, Brisbane, QLD.,Royal Brisbane and Women's Hospital, Brisbane, QLD
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29
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Mohapatra RK. Monkeypox breakthrough infections and side-effects: Clarion call for nex-gen novel vaccine. New Microbes New Infect 2023; 52:101084. [PMID: 36694837 PMCID: PMC9852341 DOI: 10.1016/j.nmni.2023.101084] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 01/12/2023] [Indexed: 01/22/2023] Open
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30
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Gravett RM, Marrazzo J. An Ulcer by Any Other Name. Infect Dis Clin North Am 2023; 37:369-380. [PMID: 37005160 DOI: 10.1016/j.idc.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
The myriad presentations of ulcerative sexually transmitted infections, other than genital herpes and syphilis, challenge even the most astute clinician given the considerable overlap in clinical presentation and lack of widely available diagnostic resources, such as nucleic acid testing, to confirm the diagnosis. Even so, case prevalence is relatively low, and incidence of chancroid and granuloma inguinale are declining. These diseases still cause substantial morbidity and increased chance for HIV acquisition, and with the recent advent of mpox as a cause, it remains imperative to identify and treat accurately.
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Affiliation(s)
- Ronnie M Gravett
- Division of Infectious Diseases, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, THT 215, 1900 University Boulevard, Birmingham, AL 35294, USA.
| | - Jeanne Marrazzo
- Division of Infectious Diseases, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, THT 215, 1900 University Boulevard, Birmingham, AL 35294, USA
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31
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Titanji BK, Marconi VC. Vaxxing to elimination: smallpox vaccines as tools to fight mpox. J Clin Invest 2023; 133:167632. [PMID: 36647829 PMCID: PMC9843044 DOI: 10.1172/jci167632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Boghuma K. Titanji
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.,Atlanta Veterans Affairs Medical Center, Decatur, Georgia, USA
| | - Vincent C. Marconi
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.,Atlanta Veterans Affairs Medical Center, Decatur, Georgia, USA.,Department of Global Health, Emory University, Atlanta, Georgia, USA.,Emory University Vaccine Center, Atlanta, Georgia, USA
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32
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Agunbiade S, Burton F, Muirhead J, Whitlock GG, Girometti N. Clinical characteristics of mpox infection in individuals who received a first dose of modified vaccinia Ankara immunisation. Sex Transm Infect 2023; 99:198-199. [PMID: 36596674 PMCID: PMC10176390 DOI: 10.1136/sextrans-2022-055698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/26/2022] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION A key part of the response to the mpox (monkeypox) epidemic has been the vaccination campaign targeted at gay, bisexual and other men who have sex with men (GBM), including people living with HIV (PLWH). METHODS We undertook a single-site, retrospective analysis of individuals who received a single dose of modified vaccinia Ankara (MVA-BN) prior to the onset of mpox symptoms. Demographics, clinical characteristics and patient management were analysed. RESULTS Of 10 068 individuals who received a first dose of the MVA-BN vaccination, 15 (0.15%) developed mpox subsequently. All individuals identified were GBM with 12/15 (80%) on Pre-exposure prophylaxis (PrEP) and 3/15 (20%) PLWH. Median time from MVA-BN inoculum to mpox symptoms was 4 days (IQR 3-9), systemic symptoms and supportive medical treatment required were common (11/15 patients, 73%) and all had localising skin lesions. One individual required hospitalisation. CONCLUSIONS Although clinical presentation was similar to unvaccinated cohorts, we observed low numbers of mpox cases following a first dose of MVA-BN vaccination. Larger, multicentric studies are needed to further evaluate vaccination failure and immunity duration.
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Affiliation(s)
| | - Felicity Burton
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Jessica Muirhead
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | | | - Nicolò Girometti
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
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33
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Lee MS, Chao YC, Hu BS, Liu C. Breakthrough monkeypox infection in a Taiwanese male with human immunodeficiency virus 6 days after vaccination. DERMATOL SIN 2023. [DOI: 10.4103/ds.ds-d-22-00136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
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34
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Merad Y, Gaymard A, Cotte L, Perpoint T, Alfaiate D, Godinot M, Becker A, Cannesson O, Batalla AS, Oria-Yassir F, Landré S, Morfin F, Bouscambert M, Valour F, Ader F, Conrad A. Outcomes of post-exposure vaccination by modified vaccinia Ankara to prevent mpox (formerly monkeypox): a retrospective observational study in Lyon, France, June to August 2022. Euro Surveill 2022; 27:2200882. [PMID: 36695469 PMCID: PMC9808316 DOI: 10.2807/1560-7917.es.2022.27.50.2200882] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Modified vaccinia virus Ankara vaccine (MVA-BN; Bavarian Nordic) is recommended to contacts of mpox cases up to 14 days post-exposure but the effectiveness of this strategy is unknown. Among 108 adults (≥ 18 years old) who received one dose of MVA-BN after exposure to mpox, 11 (10%) cases of breakthrough mpox were observed. Sexual exposure was associated with the risk of breakthrough mpox (p = 0.0179). Samples taken from vaccinated breakthrough mpox cases had similar rates of infectious virus isolation than unvaccinated mpox cases.
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Affiliation(s)
- Yanis Merad
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Alexandre Gaymard
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Laboratoire de Virologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Laurent Cotte
- Centre Gratuit D'Information, de Dépistage et de Diagnostic (CeGIDD), Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Thomas Perpoint
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Dulce Alfaiate
- Centre Gratuit D'Information, de Dépistage et de Diagnostic (CeGIDD), Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Matthieu Godinot
- Centre Gratuit D'Information, de Dépistage et de Diagnostic (CeGIDD), Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Agathe Becker
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Olivier Cannesson
- Centre Gratuit D'Information, de Dépistage et de Diagnostic (CeGIDD), Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Anne-Sophie Batalla
- Centre Gratuit D'Information, de Dépistage et de Diagnostic (CeGIDD), Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Fatima Oria-Yassir
- Centre Gratuit D'Information, de Dépistage et de Diagnostic (CeGIDD), Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Sophie Landré
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Florence Morfin
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Laboratoire de Virologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Maude Bouscambert
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Laboratoire de Virologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Florent Valour
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Florence Ader
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Anne Conrad
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
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35
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Winters M, Malik AA, Omer SB. Attitudes towards Monkeypox vaccination and predictors of vaccination intentions among the US general public. PLoS One 2022; 17:e0278622. [PMID: 36454991 PMCID: PMC9714903 DOI: 10.1371/journal.pone.0278622] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/18/2022] [Indexed: 12/03/2022] Open
Abstract
Amidst an unprecedented Monkeypox outbreak, we aimed to measure knowledge, attitudes, practices and Monkeypox vaccination intentions among the U.S. adult population. We conducted an online cross-sectional survey, representative of the U.S. adult general public in June 2022. We asked participants whether they would receive a Monkeypox vaccine, if they were recommended to do so. Participants also answered questions on their self-assessed level of Monkeypox knowledge, risk perception, perceived exaggeration of the threat, and self-efficacy around Monkeypox. Furthermore, we asked about their trusted sources of information, COVID-19 vaccination status and administered the 6-item Vaccine Trust Indicator (VTI). Survey weights were created based on age, gender and race. We analyzed predictors of Monkeypox vaccination intentions using logistic regression, adjusted for education, age, race and ethnicity. A total of 856 respondents completed the survey, of which 51% (n = 436) were female and 41% (n = 348) had a college degree or higher. If recommended, 46% of respondents intended to get vaccinated against Monkeypox, 29% would not get vaccinated and 25% did not know. Almost half the respondents (47%) found their own knowledge level about Monkeypox poor or very poor. The most trusted sources of information about the outbreak were healthcare professionals and officials, but also known doctors and researchers with a large online following. Only 24% indicated that the U.S. Centers for Disease Control and Prevention should be in charge of the outbreak response. Being vaccinated against COVID-19 was a strong predictor of intention to receive a Monkeypox if recommended (adjusted Odds Ratio (aOR) 29.2, 95% Confidence Interval (CI) 13.1-65.3). Increased risk perception was positively associated with vaccination intentions (aOR 2.6, 95% CI 1.8-3.6), scoring high on the VTI as well (5.4, 95% CI (3.2-9.1). The low levels of self-assessed knowledge, vaccination intentions and influence of COVID-19 vaccination status point to a lack of clear communication.
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Affiliation(s)
- Maike Winters
- Yale Institute for Global Health, New Haven, Connecticut, United States of America
- Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Amyn A Malik
- Yale Institute for Global Health, New Haven, Connecticut, United States of America
- Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Saad B Omer
- Yale School of Medicine, New Haven, Connecticut, United States of America
- Yale School of Public Health, New Haven, Connecticut, United States of America
- Yale School of Nursing, Orange, Connecticut, United States of America
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36
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Berens-Riha N, De Block T, Rutgers J, Michiels J, Van Gestel L, Hens M, Kenyon C, Bottieau E, Soentjens P, van Griensven J, Brosius I, Ariën KK, Van Esbroeck M, Rezende AM, Vercauteren K, Liesenborghs L. Severe mpox (formerly monkeypox) disease in five patients after recent vaccination with MVA-BN vaccine, Belgium, July to October 2022. Euro Surveill 2022; 27:2200894. [PMID: 36695462 PMCID: PMC9716643 DOI: 10.2807/1560-7917.es.2022.27.48.2200894] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Vaccination is important in containing the 2022 mpox (formerly monkeypox) epidemic. We describe five Belgian patients with localised severe symptoms of proctitis and penile oedema, occurring between 4 and 35 days after post-exposure preventive vaccination or after one- or two-dose off-label pre-exposure preventive vaccination with MVA-BN vaccine. Genome sequencing did not reveal evidence for immune escape variants. Healthcare workers and those at risk should be aware of possible infections occurring shortly after vaccination and the need for other preventive measures.
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Affiliation(s)
| | | | | | | | | | - Matilde Hens
- Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Chris Kenyon
- Institute of Tropical Medicine, Antwerp, Belgium,University of Cape Town, Cape Town, South Africa
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