Table 5

Recommandations on pre-exposure and post-exposure prophylaxis

China (MoH)54China2003A smallpox vaccineIndividuals after contact with suspected animal or human case.NS
Dermatology Advisor47Global2017A smallpox vaccineIndividuals at risk of infection prior to exposure. Contraindication: immunecompromised individuals, that is,
T-cell deficiency, HIV with CD4 <200, or by medication.
VIGIn immunecompromised patients. Notes that VIG should only be used in severe disease.
DermNet48Global2014A smallpox vaccineAll healthcare workers and all close contacts with infected cases.NS
eMedicine49Global2020ACAM2000 and Jynneos≤2 weeks, ideally ≤4 days. Exposed healthcare workers, household contacts of confirmed cases. Note: for ACAM2000 avoid risk of spread from inoculation site to other sites and individuals.NSNotes that VIG has not shown efficacy as prophylaxis.
Ireland HPSC53Ireland2021Vaccinia,
Imvanex (third generation)
Imvanex for healthcare workers, close contacts including in outbreak settings and first responders. Can be used for individuals for whom previous smallpox vaccinations were contraindicated.NS
Medscape51Global2019Jynneos, ACAM2000Exposed healthcare workers and household contacts of confirmed cases. Note: care to avoid spread from inoculation site (ACAM 2000).NSNotes that VIG has not shown efficacy as prophylaxis.
NCDC44Nigeria2019ACAM2000, Imvamune (third generation)NS.NS
PHE/UKHSA52England2019A smallpox vaccineNS.NS
Singapore FETP46Singapore2020A smallpox vaccinePost-exposure prophylaxis within 4 days, up to 14 days.NS
Taiwan CDC45Taiwan2009VacciniaPeople who care for sick patients, or animals, study the virus or MPX epidemics who have not been vaccinated, should be vaccinated.NS
UpToDate50Global2021MVA, Imvamune and Jynneos)Contacts (expect immunocompromised patients).VIGIf immunocompromised
US CDC55USA2018Jynneos
(Imvamune, Imvanex)
For contacts of cases.VIGIf severe immunodeficiency, T-cell dysfunction if smallpox vaccination is contraindicated.
WHO18Global2019A smallpox vaccineNS.NS
  • MVA- BN, Modified Vaccinia Ankara - Bavarian Nordic; CDC, Centers for Disease Control; ECDC, European Centre for Disease Control and Prevention; FETP, Singapore Field Epidemiology Training Programme; HPSC, Health Protection Surveillance Centre; MoH, Ministry of Health; MPX, monkeypox; NCDC, Nigeria Centre for Disease Control; NS, not stated; PHE, Public Health England; UKHSA, UK Health Security Agency; VIG, vaccinia immune globulin.