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What is the susceptibility to those who were vaccinated against smallpox in the 50s as children. Is there residual cross-protection decades later?

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Greetings Dr. Jetelina,

Thank you for the clear and concise information on all of the subjects that you cover.

I am a 70 yo male that has been vaccinated for smallpox twice. Once as an adolescent and again in the early 70s in the military. My 70 yo wife has been vaccinated once as an adolescent.

Are those 'old' vaccinations effective against MPX?

Thanks again!

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founding

Good question. Any residual immunity from smallpox vaccine administered decades ago compare to immuno-naive patients? How about chickenpox vaccine or shingles vaccine?

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seems sensible that they would also start looking into gradually replacing the stockpile...but that would require thinking forward more than is lately common...

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In Montreal and Toronto, they are giving a single dose of imvamune (Jynneos) to men who have sex with men (MSM), on demand. The government apparently hasn't decided yet whether to go forward with the second dose for this group.

Do you have any insight into how effective this single does is, and how long? Any other thoughts on this strategy?

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The South Carolina Department of Health and Environment conducted a smallpox vaccination campaign in 2003-2004 for public health, emergency responders, health care personnel etc. as part of the state's preparedness program (as did many states). I also worked on smallpox disease control in my early days at CDC, in the Yugoslavian importation in particular. Some thoughts from those experiences:

1. The two-pronged needle used for Dryvax and ACAM2000 is very easy to use, is disposable, and was more acceptable to most people than a needle injection. Using it to deliver vaccinations was much more rapid and logistically easy than using needles and syringes.

2. In 2003-2004 we vaccinated several hundred people with DryVax (e.g. Department of Health and Environment staff, emergency responders, police, health care workers etc., for our bioterrorism preparedness program) and experienced one case of pericarditis, to my knowledge. We were monitoring for adverse events from the vaccination program. So the CDC estimate of risk of cardiac events from ACAM2000 may be somewhat too high.]

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So, no protections available for children?

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OHA confirmed a suspected case of hMPXV in Oregon and recommended the Jynneos vaccine was the best choice over ACAM2000. Time to start ramping up production of the former it would seem. It's a good thing the virus is not highly transmissible. An orthopox virus with Omicron contagiousness would be a nightmare.

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author

Absolutely. MPX is very different than SARS-CoV-2, and so the outbreaks and implications will be very different

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Update from Oregon. We have 3 more cases of hMPXV confirmed by OHA in three counties. This brings our confirmed case count to 6. It looks like community spread and there are probably more unreported cases out there. The lead OHA official, Dr. Tim Menza is talking about "another public health crisis."

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Clear and concise as always, thank you!

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Second and third cases confirmed in Oregon today. First case is in Lane County and reportedly has no history of travel to areas of active cases; second case also resides in Lane County and no epidemiological link found (so far) to the first case.

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Jul 1, 2022·edited Jul 1, 2022

Dr. J, I’m 67yo and was vaxxed years ago with Dryvax; do I need another vax?

FYI: When I was a child, my doctor used the smallpox vax to try to treat the cold sores around my mouth (27 at one time). I rode my bike—as I recall every couple of weeks for several weeks—to get a smallpox vax, and visited Poudre Valley Creamery afterwards for a chocolate malt.

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author

We’re waiting on clarification from ACIP. It may just mean you need one dose (instead of two)

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Please let us know if you find out one way or another. Both my older siblings got Dryvax, but I was not.

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