Immune Response to MVA-BN and Prior Smallpox Vaccination in People With HIV or at Risk for HIV Acquisition - Scorecard - MDSpire

Immune Response to MVA-BN and Prior Smallpox Vaccination in People With HIV or at Risk for HIV Acquisition

  • By

  • Yijia Li

  • Michael B Townsend

  • Shanshan Li

  • Quinn E Testa

  • Tom Medvec

  • Elizabeth A Thompson

  • Frank J Palella

  • Matthew J Mimiaga

  • James B Brock

  • Maria L Alcaide

  • Anandi N Sheth

  • Michelle Floris-Moore

  • Aruna Chandran

  • Audrey L French

  • Phyllis C Tien

  • Daniel J Merenstein

  • Michael Augenbraun

  • Anjali Sharma

  • Caitlin A Moran

  • Charles R Rinaldo

  • Bernard J C Macatangay

  • Panayampalli S Satheshkumar

  • Ken S Ho

  • August 14, 2025

  • 0 min

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Clinical Scorecard: Assessment of Immune Reactions to MVA-BN and Previous Smallpox Vaccination in Individuals with HIV or at Increased Risk of HIV Infection

At a Glance

CategoryDetail
ConditionMpox (Monkeypox) infection and immune response to vaccination
Key MechanismsSerologic response measured by anti-orthopoxvirus IgG levels following MVA-BN vaccination or historic smallpox vaccination
Target PopulationOlder adults (median age 64) with HIV or at increased risk of HIV infection
Care SettingMulticenter cohort study setting with laboratory immunologic assessment

Key Highlights

  • MVA-BN vaccination induces sustained anti-orthopoxvirus IgG levels up to 1 year regardless of HIV status.
  • Individuals born before 1973 (likely previously vaccinated for smallpox) have higher baseline IgG levels.
  • Unvaccinated individuals with HIV have lower anti-orthopoxvirus IgG levels compared to those without HIV.

Guideline-Based Recommendations

Diagnosis

  • Measure anti-orthopoxvirus IgG levels using ELISA to assess immune response post-vaccination.

Management

  • Administer MVA-BN vaccine (JYNNEOS) to individuals at risk for mpox, including those with HIV.
  • Consider two doses of MVA-BN for optimal immunogenicity.

Monitoring & Follow-up

  • Monitor IgG antibody levels longitudinally up to 12 months post-vaccination to assess sustained immunity.

Risks

  • People with HIV may have reduced neutralizing antibody responses; however, MVA-BN still induces sustained IgG.
  • Breakthrough mpox infections after MVA-BN are rare and generally milder.

Patient & Prescribing Data

Older adults with or at risk for HIV infection, including those with prior smallpox vaccination history.

MVA-BN vaccination is immunogenic and induces durable antibody responses in this population, supporting its use during mpox outbreaks.

Clinical Best Practices

  • Include HIV status and prior smallpox vaccination history when evaluating immune response to MVA-BN.
  • Use longitudinal serologic testing to guide understanding of vaccine durability in vulnerable populations.
  • Prioritize vaccination with MVA-BN in populations at increased risk for mpox, including older adults with HIV.

References

Original Source(s)

Immune Response to MVA-BN and Prior Smallpox Vaccination in People With HIV or at Risk for HIV Acquisition

  • by Yijia Li, Michael B Townsend, Shanshan Li, Quinn E Testa, Tom Medvec, Elizabeth A Thompson, Frank J Palella, Matthew J Mimiaga, James B Brock, Maria L Alcaide, Anandi N Sheth, Michelle Floris-Moore, Aruna Chandran, Audrey L French, Phyllis C Tien, Daniel J Merenstein, Michael Augenbraun, Anjali Sharma, Caitlin A Moran, Charles R Rinaldo, Bernard J C Macatangay, Panayampalli S Satheshkumar, Ken S Ho

  • August 14, 2025

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