II. Indications: Smallpox

  1. Postexposure Prophylaxis
  2. High risk of exposure as Biological Weapon

III. Indications: Monkeypox

  1. Preferred Smallpox and MonkeypoxVaccine
  2. Occupational exposure (e.g. lab workers)
  3. Post-exposure Prophylaxis (sexual or other close contact)
    1. Ideal if within 4 days of exposure
    2. May be given up to 14 days after exposure
  4. High risk patients in regions of Monkey Pox outbreaks
    1. Men who have Sex with Men
    2. Multiple sexual partners
    3. Sex workers
    4. HIV Infection (esp. those on HIV PrEP)

IV. Background

  1. Third-Generation, Replication deficient Live Vaccinia Virus Vaccine

V. Safety

  1. Considered safe in Immunocompromised patients

VI. Dosing

  1. Two dose Vaccine (28 days apart) with Immunity developed by 2 weeks after second dose
  2. Each dose 0.1 ml intradermal in adults (0.5 ml SQ for age <18 years old)
  3. Booster dose every 4 years as needed

VII. Adverse Effects

  1. Injection site reactions are common (redness, swelling, pain)
  2. Minor cardiac effects in 1.3%
    1. Transient Troponin Increase
    2. EKG abnormalities
    3. Palpitations

VIII. Resources

  1. JYNNEOS- Vaccinia virus modified strain ankara-bavarian nordic non-replicating Antigen injection, suspension (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=69fc3841-a461-4706-bdcb-1176c40bf486

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