Unintentional transfer of vaccinia virus associated with smallpox vaccines

Abstract

Overall, unintentional transfer events for ACAM2000® and Dryvax® are similar. We recommend continued efforts to prevent transfer events and continuing education for healthcare providers focused on recognition of vaccinia lesions, proper sample collection, and laboratory testing to confirm diagnosis.

A randomized phase 3 trial to assess the immunogenicity and safety of 3 consecutively produced lots of freeze-dried MVA-BN® vaccine in healthy adults

“…These live vaccines were then replaced by cell-cultured poxvirus vaccines (ACAM2000, CCSV), which still contained replicating virus. The cell-cultured vaccines were found to have similar safety concerns [36] , [37] , including, as previously noted, the occurrence of acute myocarditis and pericarditis, as well as the potential for local replication and onward transmission. MVA-BN was developed as a safer, nonreplicating vaccine in a liquid-frozen formulation administered by subcutaneous injection, rather than by skin scarification with a bifurcated needle.…”

A Review of Monkeypox Ocular Manifestations and Complications: Insights for the 2022 Outbreak

“…The incidence of ocular vaccinia following smallpox vaccination is about 10 to 20 cases per 1 million primary immunizations, and it is associated with more complications compared with revaccinated cases [33]. While the risk of this event was estimated to be the same between the two traditional smallpox vaccines, Dryvax, also known as ACAM2000 [37], the newly approved non-replicating vaccine for smallpox, and MPXV, MVA-BN (Modified Vaccinia Ankara-Bavarian Nordic) vaccine, do not lead to the development of ocular vaccinia.…”

Acral papulovesicular eruption to smallpox vaccination

“…Adverse reactions range in severity and typically involve skin; including urticaria, autoinoculation, erythema multiforme and nonspecific dermatidites. Potentially more serious adverse effects include but are not limited to eczema vaccinatum, generalized vaccinia, Stevens Johnson Syndrome, myocarditis and encephalitis [6]. This particular case appears to represent a unique response pattern that has been previously referred to as a benign, acral papulovesicular eruption.…”