Clinical Scorecard: Neutralizing Antibody Responses to Mpox Persist for Up to 9 Months After One or Two Doses of Intradermal MVA-BN Vaccination in Sweden
At a Glance
Category
Detail
Condition
Mpox (Monkeypox virus infection)
Key Mechanisms
Neutralizing antibody responses to clade IIb monkeypox virus following intradermal MVA-BN vaccination; antibody waning over time
Target Population
Primarily gay, bisexual, and other men who have sex with men (GBMSM) at risk of mpox
Care Setting
Outpatient vaccination clinics (e.g., Venhälsan clinic, Stockholm, Sweden)
Key Highlights
Neutralizing antibodies to mpox virus wane significantly at 3 and 9 months after intradermal MVA-BN vaccination.
One or two doses of intradermal MVA-BN vaccine induce measurable neutralizing antibodies in GBMSM populations.
Smallpox vaccination status influences antibody kinetics; prior smallpox vaccination affects baseline and post-vaccination titers.
Guideline-Based Recommendations
Diagnosis
Assess mpox risk behaviors as per European Centre for Disease Prevention and Control criteria.
Exclude prior mpox infection before vaccination.
Management
Administer intradermal MVA-BN vaccine as two 0.1 mL doses at least 28 days apart for smallpox-unvaccinated individuals.
Administer a single dose for individuals with prior smallpox vaccination.
Consider dose-sparing intradermal vaccination regimen in at-risk populations.
Monitoring & Follow-up
Monitor neutralizing antibody titers post-vaccination at 1, 3, and 9 months to assess waning immunity.
Collect clinical and immunological data including HIV status and CD4 counts to evaluate vaccine response.
Risks
Potential waning of neutralizing antibodies over time may reduce long-term protection.
Limited global vaccine supply necessitates dose-sparing strategies.
Patient & Prescribing Data
GBMSM at risk for mpox, stratified by smallpox vaccination history and HIV status
Intradermal MVA-BN vaccination induces neutralizing antibodies that decline over 9 months; booster dosing and immunological memory require further investigation.
Clinical Best Practices
Use intradermal MVA-BN vaccination as a dose-sparing strategy in at-risk populations.
Screen patients for prior smallpox vaccination to tailor dosing schedule (single vs two doses).
Incorporate longitudinal antibody monitoring to inform potential booster needs.
Ensure ethical approval and informed consent for vaccination and data collection.
Maintain secure and pseudonymized data handling for patient confidentiality.
by Carmen Espinosa-Gongora, Wanda Christ, Núria Mayola Danés, Claudia Eichler-Jonsson, Finn Filén, Elisabet Storgärd, Victor Westergren, Jonas Klingström, Sara Gredmark-Russ, Kari Johansen, Anna Mia Ekström, Klara Sondén
