Progress and prospects on vaccine development against monkeypox infection.

Area of Science:

• Virology and Immunology
• Public Health
• Vaccine Development

Background:

• Monkeypox virus (MPOX), an orthopoxvirus (OPXV), causes a zoonotic illness with smallpox-like symptoms.
• Global outbreaks, including in the U.S., underscore the persistent public health concern of naturally occurring OPXV infections.
• Previous smallpox vaccination provided cross-protection, but its efficacy against current MPOX strains requires verification due to waning immunity.

Purpose of the Study:

• To review current and emerging vaccine strategies for monkeypox virus (MPOX) prevention.
• To assess the effectiveness, safety, and reactogenicity of various MPOX vaccine candidates.
• To provide an overview of different vaccine platforms being developed for MPOX.

Main Methods:

• Review of existing literature on MPOX epidemiology and vaccine development.
• Analysis of different vaccine types: replicating, low-replicating, non-replicating, inactivated, live-attenuated, virus-like particles (VLPs), recombinant protein, nucleic acid, and nanoparticle-based vaccines.
• Evaluation of vaccine attributes including efficacy, safety, reactogenicity, and cytotoxicity.

Main Results:

• Smallpox vaccination historically demonstrated approximately 85% efficacy against MPOX.
• WHO-approved MPOX vaccines include replicating (ACAM2000), low-replicating (LC16m8), and non-replicating (MVA-BN) types.
• Multiple novel vaccine candidates utilizing diverse platforms are under development and evaluation.

Conclusions:

• Developing specific and effective MPOX vaccines is crucial for controlling current and future outbreaks.
• Comprehensive assessment of vaccine safety and efficacy, especially in vulnerable populations, is essential.
• Continued research into various vaccine strategies is vital to address the re-emergence of MPOX.