Preventing the Next Pandemic: Is Live Vaccine Efficacious against Monkeypox, or Is There a Need for Killed Virus and mRNA Vaccines?

Abstract

(1) Background: The monkeypox virus (MPV) is a double-stranded DNA virus belonging to the Poxviridae family, Chordopoxvirinae subfamily, and Orthopoxvirus genus. It was called monkeypox because it was first discovered in monkeys, in a Danish laboratory, in 1958. However, the actual reservoir for MPV is still unknown. (2) Methods and Results: We have reviewed the existing literature on the options for Monkeypox virus. There are three available vaccines for orthopoxviruses—ACAM2000, JYNNEOS, and LC16—with the first being a replicating vaccine and the latter being non- or minimally replicating. (3) Conclusions: Smallpox vaccinations previously provided coincidental immunity to MPV. ACAM2000 (a live-attenuated replicating vaccine) and JYNNEOS (a live-attenuated, nonreplicating vaccine) are two US FDA-approved vaccines that can prevent monkeypox. However, ACAM2000 may cause serious side effects, including cardiac problems, whereas JYNNEOS is associated with fewer complications. The recent outbreaks across the globe have once again highlighted the need for constant monitoring and the development of novel prophylactic and therapeutic modalities. Based on available data, there is still a need to develop an effective and safe new generation of vaccines specific for monkeypox that are killed or developed into a mRNA vaccine before monkeypox is declared a pandemic.

Mapping trends and hotspots regarding clinical research on monkeypox: A bibliometric analysis of global research

“…However, the development of an effective and safe new generation human monkeypox vaccine is extremely necessary due to the serious complications that may result from vaccination of ACAM2000 and JYNNEOS. [28,29] Establishing rapid diagnostic testing and laboratory response networks for surveillance and rapid detection of new cases is an important part of controlling monkeypox outbreaks. [30] It is essential to investigate the source of this outbreak, to study all possible modes of transmission and to limit further spread.…”

Human monkeypox: epidemiology, transmission, pathogenesis, immunology, diagnosis and therapeutics

“…The vaccine is marketed under the name JYNNEOOS [ 35 , 36 ]. Moreover, clinical studies for the VAC6 vaccine, a vaccination of the fourth generation, are now underway [ 37 ]. All these vaccines are made from vaccinia virus since it provides cross-protection to the orthopox viruses.…”

Nanomedicine as a Potential Tool against Monkeypox

“…Nevertheless, in immunocompromised patients, infants, pregnant or breastfeeding women, and individuals with a weak immune system, there is a residual risk of a severe or even fatal infection, and the vaccine is contraindicated. Moreover, an increased risk of adverse effects may occur in individuals presenting cardiac disease (risk for myopericardititis) or dermatologic conditions (risk for skin infection, erythema, and eczema) [ 52 , 53 ]. JYNNEOS™, based on a non-replicating virus, presents a better safety profile and less severe adverse effects [ 52 ].…”