Whither monkeypox vaccination

Monkeypox (MPX) is a virulent orthopoxvirus that is endemic in some regions of Central Africa. MPX incidence has been rising since the cessation of routine smallpox immunization. While it causes significant disease, there is limited person-to-person spread, the incidence is still relatively low, and cases are generally restricted to remote areas that are difficult to access. Therefore, initiating vaccine trials or implementing vaccination programs would be challenging. This paper considers the factors that may influence future decisions on whether MPX vaccination should be pursued.

► Monkeypox (MPX) incidence in Democratic Republic of Congo is rising.
► Traditional smallpox vaccines can provide immunity against MPX infection.
► Decision to evaluate vaccines is complex and will require risk:benefit analysis.
► Ongoing epidemiological and virological surveillance will be needed.
► Dynamic conditions will call for periodic reassessment by relevant stakeholders.