CDC advisors suggest a vaccine for weak adults in future outbreaks

Vials of the JYNNEOS Monkeypox vaccine are prepared at a pop-up vaccination clinic in Los Angeles, California on August 9, 2022.

Patrick T Fallon | AFP | Getty Images

Independent advisors to the Centers for Disease Control and Prevention on Wednesday unanimously recommended giving the two-dose Jynneos vaccine to adults at risk of Mpox in the event of future outbreaks following last year’s unprecedented epidemic.

The US started using the Jynneos vaccine, which is manufactured by the Danish company Bavarian Nordic, widely reported for the first time last summer after the Biden administration declared a public health emergency in response to the sudden domestic spread of mpox. The virus has historically been mostly confined to West and Central Africa, but has now spread to more than 100 countries.

“It is important to note that an MPOX outbreak is identified by health authorities and an individual case may be considered an MPOX outbreak at the discretion of health authorities,” said Dr. Pablo Sanchez, Head of the CDC Committee’s MPOX Working Group.

dr Agam Rao, a public health official, said the vaccine could be used in the future if mpox is introduced by a traveler or through imported animals, or if a community needs preventive vaccination due to the spread of the virus at a nearby location.

“Local health officials, state health officials, and the federal government can all determine what counts as an outbreak,” Rao said. “If there’s a single case from a traveler in the United States, that could do it.”

Advisors’ recommendation Wednesday was not specific to men who have sex with men, the community hardest hit by the current epidemic. Although mpox is currently spread primarily through sexual contact, it is unclear how the virus would be transmitted in a future outbreak and which communities could be hardest hit, Rao said.

CDC advisors will meet again in June to discuss the use of the Jynneos vaccine for children at risk of Mpox in future outbreaks. The US is currently offering the vaccine to adults and adolescents who are at risk from the current epidemic.

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Studies found that two doses of the Jynneos vaccine were at least 66% effective in preventing MPox, although other research found that the vaccines were up to 83% effective. The effectiveness of a single dose ranged from 36% to 86%, depending on the study.

It’s still unclear how effective the vaccine is for people with weakened immune systems, which is crucial given that 53% of people with MPOX in the US who disclosed their HIV status were positive.

The CDC does not currently recommend vaccination for people who have recovered from MPox because they should develop immunity to their disease, Rao said. It’s unclear if people will eventually need a booster dose, although a study is being conducted in the Democratic Republic of the Congo to answer that question, Rao said.

Serious side effects from the vaccine were rare in adults, according to the CDC, and none were noted in children. Seven cases of myocarditis and pericarditis, forms of heart inflammation, have been reported. The CDC has not found an increased risk of heart inflammation after vaccination, but has not ruled it out either.

Since May 2022, more than 30,000 cases of MPOX have been confirmed in the US. About 8% of people who contracted the virus were hospitalized and 32 died.

New cases have fallen dramatically since the August peak due to a successful vaccination campaign and greater awareness of the precautions to be taken. Although the US lifted the public health emergency in January, Rao said the current outbreak is not over.

dr Jamie Loehr, owner of Cayuga Family Medicine in Ithaca, New York, said, “This is a common disease.”

“Even now at the lowest level, we still have two cases per week, which is more than in recent years per year,” said Löhr.

Mpox is generally not fatal for most people, although it is often extremely painful, with lesions forming on sensitive areas such as the genitals.

People with severely compromised immune systems, especially those with HIV, are at much higher risk of serious illness and even death. Scientists found the death rate for people with advanced HIV who contracted MPox was 15% in a study of 382 cases published Tuesday in The Lancet.

More than 1 million doses of Jynneos have been administered during the current outbreak. The Food and Drug Administration approved the Jynneos vaccine in 2019 to prevent smallpox and mpox, which are related viruses.

The World Health Organization last year changed the name of the virus, originally called monkeypox, to reduce stigma.

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