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CDC advisors recommend the vaccine for at-risk adults in future outbreaks

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Vials of JYNNEOS Monkeypox vaccine are prepared at a pop-up vaccination clinic in Los Angeles, California on August 9, 2022.

Patrick T. Fallon | AFP | Getty Images

Independent advisers to the Centers for Disease Control and Prevention unanimously recommended on Wednesday that after last year’s unprecedented outbreak, the two-dose Jynneos vaccine be given to adults at risk of mpox in the event of future outbreaks.

The US has started using the Jynneos vaccine, made by a Danish company Bavarian Nordic, widely for the first time last summer after the Biden administration declared a public health emergency in response to the sudden spread of mpox domestically. The virus was historically confined mainly to West and Central Africa, but has now spread to more than 100 countries.

“It is important to note that mpox outbreaks will be determined by public health authorities and one case may be considered an mpox outbreak at the discretion of the public health authority,” said Dr. Pablo Sanchez, head of the mpox task force of the CDC committee. .

Dr. Agam Rao, an officer in the public health service, said the vaccine could be deployed in the future if mpox is introduced by travelers or through imported animals, or if there is a need to immunize the community as a precaution against the spread of the virus in a nearby location.

“Local health departments, state health departments, federal agencies can decide what’s considered an outbreak,” Rao said. “If there’s a single case from a traveler in the United States, then that might be enough.”

The advisers’ recommendation Wednesday was not specific to men who have sex with men, the community most affected by the current epidemic. Although mpox is currently spread mainly through sexual contact, Rao said it is unclear how the virus would be transmitted in a future outbreak and which communities might be most affected.

CDC advisors will meet again in June to discuss the use of the Jynneos vaccine for children at risk of mpox in future outbreaks. The US is currently offering the vaccine to adults and adolescents who are at risk in the current epidemic.

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Studies have found that two doses of the Jynneos vaccine were at least 66% effective in preventing mpox, although other investigations have found the injections to be as effective as 83%. The effectiveness of a single dose ranged from 36% to 86% depending on the study.

It’s still unclear how effective the vaccine is for people with weak immune systems, which is crucial given that 53% of people with mpox in the US who disclosed their HIV status tested positive.

The CDC currently does not recommend vaccination for people who have recovered from mpox because they should develop immunity to their disease, Rao said. It’s unclear whether people may need a booster at some point, with a study being conducted in the Democratic Republic of Congo to help answer that question, Rao said.

According to the CDC, serious side effects from the vaccine were rare in adults and none in children. Seven cases of myocarditis and pericarditis, forms of inflammation of the heart, were reported. The CDC did not find an increased risk of heart inflammation after vaccination, but it also did not rule it out.

As of May 2022, more than 30,000 cases of mpox have been confirmed in the US. About 8% of people who contracted the virus were hospitalized and 32 died.

New cases have fallen dramatically since the August peak thanks to a successful vaccination campaign and greater awareness of what precautions to take. Although the US lifted the public health emergency in January, Rao said the current epidemic is not over.

Dr. Jamie Loehr, owner of Cayuga Family Medicine in Ithaca, New York, said “this is a common condition.”

“Even now at the lowest level, we still have two cases a week, which is more than a year in the last few years,” Loehr said.

Mpox is generally not fatal for most people, although it is often extremely painful, with lesions often forming on sensitive areas such as the genitals.

People with severely weakened immune systems, especially those living with HIV, face a much higher risk of serious illness and even death. The researchers found that the death rate for people with advanced HIV who contracted mpox was 15% in a study of 382 cases. published Tuesday in The Lancet.

More than 1 million doses of Jynneos have been administered during the current outbreak. The Food and Drug Administration approved the Jynneos vaccine in 2019 to prevent chickenpox and mpox, which are related viruses.

The World Health Organization last year changed the name of the virus, originally called monkeypox, to reduce stigma.

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