Vaccines and immunization for monkeypox: Interim guidance, 14 June 2022

https://www.who.int/publications-detail-redirect/who-mpx-immunization-2022.1

Vaccines and immunization for monkeypox
Interim guidance (Download Here)

14 June 2022
Key points
The goal of the global outbreak response for monkeypox is to control the outbreak, and to effectively use public health measures to prevent onward spread of the disease. Judicious use of vaccines can support this response.

This interim guidance provides the first WHO recommendations on use of vaccines for monkeypox. They will be updated as information becomes available.

General
• Monkeypox is an infectious disease caused by the monkeypox virus (MPXV). This double-stranded DNA virus is a member of the Orthopoxvirus genus in the Poxviridae family, related to the virus which caused smallpox (eradicated in 1980).
• Control of monkeypox outbreaks primarily relies on public health measures including surveillance, contact-tracing, isolation and care of patients.

While smallpox vaccines are expected to provide some protection against monkeypox, clinical data are limited.
• Most interim vaccination recommendations provided here concern off-label use.

Vaccines
• Some countries have maintained strategic supplies of older smallpox vaccines from the Smallpox Eradication Programme (SEP) which concluded in 1980. These first-generation vaccines held in national reserves are not recommended for monkeypox at this time, as they do not meet current safety and manufacturing standards.
• Many years of research have led to development of new and safer (second- and third-generation) vaccines for smallpox, some of which may be useful for monkeypox and one of which (MVA-BN) has been approved for prevention of monkeypox.
• The supply of newer vaccines is limited and access strategies are under discussion.
Summary of interim recommendations
• Based on currently assessed risks and benefits and regardless of vaccine supply, mass vaccination is not required nor recommended for monkeypox at this time.
Human-to-human spread of monkeypox can be controlled by public health measures including early case-finding, diagnosis and care, isolation and contact-tracing.
• All decisions around immunization with smallpox or monkeypox vaccines should be by shared clinical decision-making, based on a joint assessment of risks and benefits, between a health care provider and prospective vaccinee, on a case-by-case basis.
Post-exposure prophylaxis (PEP): For contacts of cases, PEP is recommended with an appropriate
second- or third-generation vaccine, ideally within four days of first exposure (and up to 14 days in the absence of symptoms), to prevent onset of disease.
Pre-exposure prophylaxis (PrEP): PrEP is recommended for health workers at high risk of exposure, laboratory personnel working with orthopoxviruses, clinical laboratory personnel performing diagnostic testing for monkeypox, and outbreak response team members as may be designated by national public health authorities.


What is: Post-exposure prophylaxis, also known as post-exposure prevention (PEP), is any preventive medical treatment started after exposure to a pathogen in order to prevent the infection from occurring.

What is: Pre-exposure prophylaxis is the use of medications used to prevent the spread of disease in people who have not yet been exposed to a disease-causing agent, usually a virus. The term typically refers to the specific use of antiviral drugs as a strategy for HIV/AIDS prevention


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