Skip to main content

Effect of #JYNNEOS #vaccination on #mpox clinical #progression: a case–control study

Image
By G.M.

Summary

Background

The JYNNEOS modified vaccinia virus Ankara vaccine is effective in preventing clade IIb mpox disease. However, vaccine effects on mpox severity are poorly understood. We aimed to assess associations between reported clinical characteristics and vaccination status among individuals with laboratory-confirmed mpox.

Methods

We conducted a case–control study using data collected from public health surveillance interviews of people with mpox in California. Eligible participants for primary analyses were men who were cisgender and participated in telephone interviews with complete responses recorded about anatomical sites where they had lesions. We estimated JYNNEOS vaccine effectiveness against progression to disease involving disseminated lesions via the adjusted odds ratio of vaccination, comparing participants who reported lesions disseminated across multiple anatomical regions (cases) with participants who reported lesions contained to a single anatomical region (controls). We used the same case–control framework to estimate vaccine effectiveness against progression to hospitalisation and prodromal symptoms.

Findings

Men who were cisgender represented 5763 (94·3%) of 6112 people reported to have laboratory-confrimed mpox in California from May 12, 2022, to Dec 31, 2023, among whom, 4609 (79·9%) met eligibility criteria and were included in primary analyses. Of 4609 participants, 1566 (34·0%) were classified as controls and 3043 (66·0%) were classified as cases. Among 3043 cases, 114 (3·7%) received pre-exposure vaccination and 214 (7·0%) received post-exposure vaccination only. Among 1566 controls, 285 (18·2%) received pre-exposure vaccination and 146 (9·3%) received post-exposure vaccination only. For pre-exposure vaccination, vaccine effectiveness against progression was 58·8% (95% CI 50·3–65·9); for post-exposure vaccination, vaccine effectiveness against progression was 15·9% (3·3–26·8). Pre-exposure vaccine effectiveness against progression was 66·6% (56·8–74·2) among people negative for HIV and 44·8% (27·5–58·0) for those with HIV. Pre-exposure vaccination was also associated with protection against progression to severe illness necessitating hospitalisation (85·4% [95% CI 54·3–95·3]), and with reduced odds for fever, chills, and lymphadenopathy.

Interpretation

Among men who were cisgender with mpox, pre-exposure vaccination with JYNNEOS was associated with less severe illness. Awareness of an attenuated disease phenotype involving localised lesions without accompanying prodromal symptoms is needed to ensure accurate diagnosis of mpox in previously vaccinated individuals.

Source: Lancet Infectious Diseases, https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(25)00180-X/fulltext?rss=yes

____

Labels:

Comments

Post a Comment

Popular posts from this blog

#Neuroinvasive #Oropouche virus in a patient with #HIV from extra-Amazonian #Brazil

By G.M.
{Excerpt} A novel reassortant Oropouche virus (OROV) lineage (with medium [M], large [L], and small [S] RNA segments : M1L2S2) has driven Brazil's largest and most geographically widespread OROV epidemic , expanding beyond the endemic Amazon basin to establish local transmission across multiple Brazilian states and other previously unaffected Latin American countries . The rapid spread of this lineage underscores its evolutionary potential and reinforces its significance as a public health threat .1 Similar to chikungunya and Zika viruses, expanding arboviruses can exhibit unexpected clinical and epidemiological shifts , including vertical transmissions , neuroinvasive effects, and potentially fatal outcomes.2–4 Although OROV typically causes self-limited febrile illness, accumulating clinical and experimental evidence suggests neurotropic potential .5 This Correspondence describes the first confirmed case of neuroinvasive OROV infection caused by the emergent M1L2S2 lineage in ext...
Post a Comment
Read more »

No evidence of immune #exhaustion after repeated #SARS-CoV-2 #vaccination in vulnerable and healthy populations

By G.M.
Abstract Frequent SARS-CoV-2 vaccination in vulnerable populations has raised concerns that this may contribute to T cell exhaustion , which could negatively affect the quality of immune protection. Herein, we examined the impact of repeated SARS-CoV-2 vaccination on T cell phenotypic and functional exhaustion in frail older adults in long-term care (n = 23), individuals on immunosuppressive drugs (n = 10), and healthy adults (n = 43), in Canada . Spike-specific CD4+ and CD8+ T cell levels did not decline in any cohort following repeated SARS-CoV-2 vaccination, nor did the expression of exhaustion markers on spike-specific or total T cells increase. T cell production of multiple cytokines (i.e. polyfunctionality) in response to the spike protein of SARS-CoV-2 did not decline in any cohort following repeated vaccination. None of the cohorts displayed elevated levels of terminally differentiated T cells following multiple SARS-CoV-2 vaccinations. Thus, repeated SARS-CoV-2 vaccination was...
Post a Comment
Read more »

Chimeric #hemagglutinin and #M2 #mRNA #vaccine for broad #influenza subtype protection

By G.M.
Abstract Since multiple and unpredicted influenza viruses cause seasonal epidemics and even high-risk pandemics , developing a universal influenza vaccine is essential to provide broad protection against various influenza subtypes. Combined with the mRNA lipid nanoparticle-encapsulated (mRNA-LNP) vaccine platform and chimeric immunogen strategy , we developed a novel cocktail mRNA vaccine encoding chimeric HAs (cH5/1-BV, cH7/3) and intact M2 (termed Fluaxe), which confers broad protection against major circulating IAVs and IBVs , as well as highly pathogenic avian influenza . Two-dose intramuscular immunization of Fluaxe in mice elicited cross-reactive neutralizing antibodies , T cell responses, and long-lived immunity, resulting in robust protection against multiple lethal influenza virus infections and severe acute lung injuries . In particular, intramuscular administration stimulated systemic immunity together with a prominent lung tropism of memory cells . Moreover, Fluaxe immuniza...
Post a Comment
Read more »