Vaccine Effectiveness of JYNNEOS against Mpox Disease in the United States

Deputy, Nicholas P.; Deckert, Joseph; Chard, Anna N.; Sandberg, Neil; Moulia, Danielle; Barkley, Eric; Dalton, Alexandra F.; Sweet, Charles S.; Cohn, Amanda C.; Little, David; Cohen, Adam L.; Sandmann, Danessa; Payne, Daniel C.; Gerhart, Jacqueline L.; Feldstein, Leora R.

doi:10.1056/nejmoa2215201

Cited by 134 publications

(86 citation statements)

References 15 publications

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“…During the 2022–2023 mpox outbreak, analyses of the MVA-BN vaccine (JYNNEOS) showed that one dose of MVA-BN, either SC or ID, provided 35 to 79% efficacy, and two doses of MVA-BN, either SC or ID, provided 66 to 90% efficacy, depending on the exact study and its parameters ( 16 – 24 ). Our data in macaques are consistent with these clinical data, showing partial protection with the MVA-BN vaccine.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the immunogenicity and protective efficacy of ACAM2000, MVA, and vectored subunit vaccines for Mpox in rhesus macaques

Jacob-Dolan,

Ty,

Hope

et al. 2024

Sci. Transl. Med.

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The 2022–2023 mpox outbreak triggered vaccination efforts using smallpox vaccines that were approved for mpox, including modified vaccinia Ankara (MVA; JYNNEOS), which is a safer alternative to live replicating vaccinia virus (ACAM2000). Here, we compare the immunogenicity and protective efficacy of JYNNEOS by the subcutaneous or intradermal routes, ACAM2000 by the percutaneous route, and subunit Ad35 vector–based L1R/B5R or L1R/B5R/A27L/A33R vaccines by the intramuscular route in rhesus macaques. All vaccines provided robust protection against high-dose intravenous mpox virus challenge with the current outbreak strain, with ACAM2000 providing near complete protection and JYNNEOS and Ad35 vaccines providing robust but incomplete protection. Protection correlated with neutralizing antibody responses as well as L1R/M1R- and B5R/B6R-specific binding antibody responses, although additional immune responses likely also contributed to protection. This study demonstrates the protective efficacy of multiple vaccine platforms against mpox virus challenge, including both current clinical vaccines and vectored subunit vaccines.

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Section: Discussionmentioning

confidence: 99%

Comparison of the immunogenicity and protective efficacy of ACAM2000, MVA, and vectored subunit vaccines for Mpox in rhesus macaques

Jacob-Dolan,

Ty,

Hope

et al. 2024

Sci. Transl. Med.

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“…For one MVA-BN dose, VE estimates range from 36%-86%, 19–23 and for two doses from 66% to 89%. 21–23 Persons who received a childhood smallpox vaccination were also included in the referenced studies. Those persons would have been considered fully vaccinated after one MVA-BN vaccination in our definition.…”

Section: Discussionmentioning

confidence: 99%

Factors that influenced the course of the mpox outbreak in the Netherlands, 2022-2023

Haverkate,

Willemstein,

van Ewijk

et al. 2023

Preprint

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BackgroundIn 2022-2023 a global outbreak of mpox affected mostly gay, bisexual and other men having sex with men (GBMSM). Outbreak control in the Netherlands included isolation, quarantine, post-exposure prophylaxis vaccination, and primary preventive vaccination (PPV). We describe the course of the outbreak, the vaccination programme, vaccine effectiveness (VE) of full vaccination against symptomatic disease, and trends in behaviour to generate hypotheses about factors that influenced the outbreak’s decline.MethodsObservational study. Data on notified cases, number of PPV invitations, and PPV doses administered were collected from public health services. PPV uptake and coverage were calculated. Monthly trends in behavioural data of GBMSM visiting Sexual Health Centres (SHC) were analysed for all consultations in 2022. VE was estimated using the screening method.FindingsA total of 1,266 mpox cases were reported until August 1, 2023. The outbreak peaked early July 2022 and sharply declined afterwards. PPV started July 25, 2023; in total 29,851 doses were administered. 45.8% received at least one dose, 35.4% was fully vaccinated. Estimated VE was 68.2% (95% CI 4.3%-89.5%). In our analyses of behavioural data, we did not observe an evident decrease in high-risk behaviour.InterpretationIt is unlikely that PPV was a driver of the outbreak’s decline, as incidence started to decline well before the start of the PPV programme. The possible impact of behavioural change could not be demonstrated with the available indicators. We hypothesise that infection-induced immunity in high-risk groups contributed most to the decline.FundingDutch Ministry of Health, Welfare and Sport.

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“…However, the novel nonreplicating JYNNEOS vaccine has become the standard of care and early data suggest that it can prevent and attenuate the severity of mpox infection. 56…”

Section: Countermeasuresmentioning

confidence: 99%

“…The severe reactions caused by the live virus smallpox vaccines limited their widespread use. However, the novel nonreplicating JYNNEOS vaccine has become the standard of care and early data suggest that it can prevent and attenuate the severity of mpox infection 56 …”

Section: Countermeasuresmentioning

confidence: 99%

Optimal management of severe mpox in patients with uncontrolled human immunodeficiency virus

Shishido,

Street

2023

Journal of Medical Virology

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In May 2022, a cluster of nontravel‐related cases of human mpox were reported in the United Kingdom. The outbreak has since spread worldwide infecting over 85 000 patients and causing over 100 deaths. Recent data clearly suggest that patients infected with human immunodeficiency virus (HIV) with CD4 counts less than 200 cells per mm3 suffer significantly worse outcomes than immunocompetent patients. The available countermeasures lack robust clinical data and are deployed based on in vitro and animal studies as well as extrapolations from use against other poxviruses. In many cases, despite administration of these available treatments, initiation of antiretroviral therapy (ART), and management of suspected immune reconstitution inflammatory syndrome after initiating ART, patients die. This review summarizes available data, identifies knowledge gaps and proposes recommendations on the management of severe mpox in people living with HIV.

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Vaccine Effectiveness of JYNNEOS against Mpox Disease in the United States

Cited by 134 publications

References 15 publications

Comparison of the immunogenicity and protective efficacy of ACAM2000, MVA, and vectored subunit vaccines for Mpox in rhesus macaques

Comparison of the immunogenicity and protective efficacy of ACAM2000, MVA, and vectored subunit vaccines for Mpox in rhesus macaques

Factors that influenced the course of the mpox outbreak in the Netherlands, 2022-2023

Optimal management of severe mpox in patients with uncontrolled human immunodeficiency virus

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