Suspected case of monkeypox reinfection versus reactivation in a immunocompetent patient, Barcelona, 2022

Abstract

Vaccines against smallpox are known to have cross-protective activity against monkeypox, and smallpox and monkeypox infections are believed to generate permanent immunity. Nevertheless, there are scarce data about the possibility of reinfection or reactivation. Recently, a case of apparent monkeypox reinfection has been reported. We present a suspected case of second episode of monkeypox in a healthy and previously vaccinated man, with a confirmed primary monkeypox infection occurring three months before the second confirmed presentation.

Evaluation and comparison of immune responses induced by two Mpox mRNA vaccine candidates in mice

“…Given that the cases of reinfection and breakthrough infection of MPXV among vaccinated individuals, 12–17 potential safety concerns, 18 and risk for lack of effectiveness and relatively low levels of neutralizing antibodies against MPXV induced by JYNNEOS and ACAM2000, 25 it becomes obvious that smallpox vaccines and natural immunity sometimes might fail in providing enough protection against MPXV. Therefore, MPXV vaccines should be based more on specific and designated targets instead on attenuated viruses.…”

“…These results indicated that the mRNA vaccine candidate MPXfus and MPXmix were capable of inducing neutralizing antibodies against poxvirus. Given that the cases of reinfection and breakthrough infection of MPXV among vaccinated individuals, [12][13][14][15][16][17] potential safety concerns, 18 and risk for lack of effectiveness and relatively low levels of neutralizing antibodies against MPXV induced by JYNNEOS and ACAM2000, 25 response to epidemics of infectious diseases. 19 Recently, four manuscripts posted on biorxiv as preprint documents and three research articles demonstrated seven mRNA vaccines against MPXV are being developed.…”

“…10,11 However, potential safety concerns, cases of reinfection, and breakthrough infection make these two smallpox vaccines far from the medical demand worldwide. [12][13][14][15][16][17][18] Therefore, safe, effective, and widely applicable vaccines for MPXV prevention are needed.…”

“…ACAM2000 is a live attenuated vaccine and JYNNEOS is a nonreplicative vaccine based on VACV Ankara strain 10,11 . However, potential safety concerns, cases of reinfection, and breakthrough infection make these two smallpox vaccines far from the medical demand worldwide 12–18 . Therefore, safe, effective, and widely applicable vaccines for MPXV prevention are needed.…”

Breakthrough infection and reinfection in patients with mpox

“…To date, 10 cases of MPXV reinfection were reported in various countries including Spain, the United Kingdom, Switzerland, Nigeria, Italy, Brazil, and others. 16,[28][29][30][31][32][33] Table 2 presents basic information of these cases.…”