Is there any evidence for milder courses of monkeypox virus infections with childhood smallpox vaccination?

Since May 2022, unusually high numbers of human monkeypox virus (MPXV) infections are being reported across Europe and other regions [1]. On July 23, 2022, WHO declared that the current outbreak represents a public health emergency of international concern and recommended targeted immunization for persons at high risk of exposure for MPXV [2]. Laboratory and animal studies, as well as epidemiological observations mainly from Africa suggest that smallpox vaccination may provide some protection against MPXV [3]. However, in a small outbreak in the US in 2003, no significant differences in serious clinical conditions or complications were seen between vaccinated and unvaccinated individuals [4]. In the absence of controlled clinical trials, we were interested if smallpox vaccination could alter the clinical picture of MPXV infection.


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