smallpox and monkey pox vaccine information

 Like the previous posts, this is my taking notes about a clinical problem that I want to learn about, so exuse the lack of well written essay.

when 911 happened, a lot of people were worried that terrorists would get hold of smallpox from rogue scientists, so they did restart the vaccination program.

I am old enough to remember when we all got this, and we had people who developed generalized vaccinia which can be rarely fatal.

So what happened in 2001?

JAMA:

Subjects US service members and DoD civilian workers eligible for smallpox vaccination. Main Outcome Measures Numbers of vaccinations and rates of vaccination exemptions, symptoms, and adverse events. Data were collected via reports to headquarters and rigorous surveillance for sentinel events. Results In 5.5 months, the DoD administered 450 293 smallpox vaccinations (70.5% primary vaccinees and 29.5% revaccinees). In 2 settings, 0.5% and 3.0% of vaccine recipients needed short-term sick leave. Most adverse events occurred at rates below historical rates. One case of encephalitis and 37 cases of acute myopericarditis developed after vaccination; all cases recovered. Among 19 461 worker-months of clinical contact, there were no cases of transmission of vaccinia from worker to patient, no cases of eczema vaccinatum or progressive vaccinia, and no attributed deaths.

of course that was in low risk people, so in a general population it would be higher (immune problems from HIV or cancer predispose to generalized vaccinia)

I could be wrong (will have to check it later) But they were using the old 1931 vaccine, but I seem to remember they were using a newer vaccine for high risk first responders, a vaccine that had fewer generalized vaccinia side effects but it was stopped because it caused myocarditis, and after a few months the realized Saddam wasn't going to spread smallpox to the USA.

so anyway, fast forward and voila, monkey pox. Something that is not very infectious but no one wants to discuss the activity in homosexual gatherings that was spreading this to the US and Europe. So these gatherings were not shut down, but the affluent white gay community spread the word to each other about the disease and the need for the vaccine. Alas, the the average non affluent bisexuals in the minority communities warned that they were at risk, so most of the deaths were in minorities.

So anyway, the present Smallpox vaccine is JYNNEOS vaccine, approved in 2019 for both smallpox and monkey pox.

Smallpox/monkeypox vaccine (JYNNEOS™) can help protect against smallpox, monkeypox, and other diseases caused by orthopoxviruses, including vaccinia virus...

Some people continue to be at risk of exposure to the virus that causes smallpox, including people who work in emergency preparedness and some laboratory workers.,,..

Smallpox/monkeypox vaccine (JYNNEOS™) is made using weakened live vaccinia virus and cannot cause smallpox, monkeypox, or any other infectious disease. JYNNEOS™ is approved by the Food and Drug Administration (FDA) for prevention of smallpox and monkeypox disease in adults 18 years or older at high risk for smallpox or monkeypox infection...

more here.

there are scattered reports out there about it's efficiency, and if you get two doses it does give good protection, so you can ignore that the basic public health shut down of places where high risk behavior goes on was never done.

here is the report of how well it worked to stop monkeypox:

apparantly there was a lot more MPox out there than I knew about: But maybe it was because it was a localized disease, in certain states and in high risk groups

During May 12, 2022–May 18, 2023, a total of 5,765 persons with mpox and 250 (4.3%) mpox-associated hospitalizations were reported among California residents

Overall, 233 (5.0%) Monkeypox virus infections occurred in persons who received 1 JYNNEOS dose, 79 (1.7%) in those who received 2 doses, 457 (9.9%) in persons who received PEP,¶ and 3,845 (83.4%) in unvaccinated persons. A total of 250 (5.4%) mpox patients were hospitalized, including four (1.6%) who received 1 JYNNEOS dose, one (0.4%) who received 2 doses, 12 (4.8%) who received PEP, and 233 (93.2%) who were unvaccinated. Compared with unvaccinated mpox patients, the odds of hospitalization among persons with mpox who received 1 dose, 2 doses, and PEP were 0.27, 0.20, and 0.42, respectively (Table 2).

PEP means pre exposure vaccination

and they gave out a lot of vaccines:

Approximately 300,000 doses of the JYNNEOS vaccine have been administered to California residents since May 26, 2022.** During this time, an estimated 64% of California’s at-risk population†† received 1 dose and 40% received 2 doses (10). Messaging to persons at higher risk for Monkeypox virus infection and persons with HIV infection should encourage completion of the 2-dose JYNNEOS vaccination series to limit virus transmission and mitigate disease severity.