Recommandations on pre-exposure and post-exposure prophylaxis
| Guideline | Country | Year | Vaccination | Indications | Immunoglobulins | Indications |
| China (MoH)54 | China | 2003 | A smallpox vaccine | Individuals after contact with suspected animal or human case. | NS | – |
| Dermatology Advisor47 | Global | 2017 | A smallpox vaccine | Individuals at risk of infection prior to exposure. Contraindication: immunecompromised individuals, that is, T-cell deficiency, HIV with CD4 <200, or by medication. | VIG | In immunecompromised patients. Notes that VIG should only be used in severe disease. |
| DermNet48 | Global | 2014 | A smallpox vaccine | All healthcare workers and all close contacts with infected cases. | NS | – |
| ECDC56 | Europe | 2019 | MVA-BN/Imvanex | NS. | NS | – |
| eMedicine49 | Global | 2020 | ACAM2000 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. | NS | Notes that VIG has not shown efficacy as prophylaxis. |
| Ireland HPSC53 | Ireland | 2021 | Vaccinia, 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 | – |
| Medscape51 | Global | 2019 | Jynneos, ACAM2000 | Exposed healthcare workers and household contacts of confirmed cases. Note: care to avoid spread from inoculation site (ACAM 2000). | NS | Notes that VIG has not shown efficacy as prophylaxis. |
| NCDC44 | Nigeria | 2019 | ACAM2000, Imvamune (third generation) | NS. | NS | – |
| PHE/UKHSA52 | England | 2019 | A smallpox vaccine | NS. | NS | – |
| Singapore FETP46 | Singapore | 2020 | A smallpox vaccine | Post-exposure prophylaxis within 4 days, up to 14 days. | NS | – |
| Taiwan CDC45 | Taiwan | 2009 | Vaccinia | People who care for sick patients, or animals, study the virus or MPX epidemics who have not been vaccinated, should be vaccinated. | NS | – |
| UpToDate50 | Global | 2021 | MVA, Imvamune and Jynneos) | Contacts (expect immunocompromised patients). | VIG | If immunocompromised |
| US CDC55 | USA | 2018 | Jynneos (Imvamune, Imvanex) | For contacts of cases. | VIG | If severe immunodeficiency, T-cell dysfunction if smallpox vaccination is contraindicated. |
| WHO18 | Global | 2019 | A smallpox vaccine | NS. | 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.