smallpox vaccine; vaccinia vaccine (Dryvax, Arestvyr, Jynneos, Ankara-Bavarian Nordic vaccine, MVA-BN vaccine)
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Introduction
Tradename: Dryvax. Only Jynneos FDA-approved[10]
Indications
- laboratory & healthcare personnel at risk for occupational exposure to orthopoxviruses
Contraindications
- Jynneos: smallpox vaccination within past 3 years
Pharmacokinetics
Adverse effects
(see vaccinia)
- severe reaction in 0.005%
- eczema vaccinatum
- encephalitis, meningitis
- Bell's palsy
- seizures
- Guillain-Barre syndrome
- myopericarditis, pericarditis[5][6]
- death
- pain, swelling & erythema at injection sit
- myalgia/arthralgia (8%)[12]
- headache (9%)[12]
- gastrointestinal symptoms (4%)[12]
- fatigue (18%)[12]
- dyspnea (1%)[12]
- palpitations (1%)[12]
Toxicity:
- vaccine antidote is available
- vaccinia immune globulin helps for some adverse effects
- cidofovir may be helpful
Mechanism of action
- vaccine does NOT contain smallpox virus (Variola major)
- vaccine contains vaccinia
- modified vaccinia Ankara (MVA) replicates for one cycle in mammalian cells & is safe & immunogenic[11]
More general terms
References
- ↑ Prescriber's Letter 9(12):72 2002
- ↑ Action Report, Medical Board of California, 85:6 (April) 2003
- ↑ http://www.cdc.gov/smallpox
- ↑ 4.0 4.1 Frey SE et al Response to smallpox vaccine in persons immunized in the distant past. JAMA 289:3295, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12824212
- ↑ 5.0 5.1 Halsell JS et al Myopericarditis following smallpox vaccination among vaccinia- naive US military personnel. JAMA 289:3283, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12824210
- ↑ 6.0 6.1 Casey CG et al, Adverse events associated with smallpox vaccination in the United States, JAMA 2005; 294:2734 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16333009 Sejvar JJ et al, Neurologic adverse events associated with smallpox vaccination in the United States, 2002-2004 JAMA 2005; 294:2744 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16333010
- ↑ Casey C, Vellozzi C, Mootrey GT, Chapman LE, McCauley M, Roper MH, Damon I, Swerdlow DL. Surveillance guidelines for smallpox vaccine (vaccinia) adverse reactions. MMWR Recomm Rep. 2006 Feb 3;55(RR-1):1-16. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16456528 Corresponding NGC guideline withdrawn Dec 2011 http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5501a1.htm
- ↑ Physician's First Watch, March 14, 2013 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
McNeil DG Wary of Attack With Smallpox, U.S. Buys Up a Costly Drug http://www.nytimes.com/2013/03/13/health/us-stockpiles-smallpox-drug-in-case-of-bioterror-attack.html - ↑ Petersen BW, Harms TJ, Reynolds MG, Harrison LH Use of Vaccinia Virus Smallpox Vaccine in Laboratory and Health Care Personnel at Risk for Occupational Exposure to Orthopoxviruses - Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2015 MMWR Weekly / March 18, 2016 / 65(10);257-262 http://www.cdc.gov/mmwr/volumes/65/wr/mm6510a2.htm
Petersen BW, Damon IK, Pertowski CA et al Clinical guidance for smallpox vaccine use in a postevent vaccination program. MMWR Recomm Rep. 2015 Feb 20;64(RR-02):1-26. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25695372 Free Article - ↑ 10.0 10.1 FDA News Release. Sept 24, 2019 FDA approves first live, non-replicating vaccine to prevent smallpox and monkeypox. https://www.fda.gov/news-events/press-announcements/fda-approves-first-live-non-replicating-vaccine-prevent-smallpox-and-monkeypox
- ↑ 11.0 11.1 Pittman PR, Hahn M, Lee HS et al. Phase 3 efficacy trial of modified vaccinia Ankara as a vaccine against smallpox. N Engl J Med 2019 Nov 14; 381:1897 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31722150 https://www.nejm.org/doi/10.1056/NEJMoa1817307
- ↑ 12.0 12.1 12.2 12.3 12.4 12.5 12.6 Deng L, Lopez LK, Glover C et al Short-term Adverse Events Following Immunization With Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN) Vaccine for Mpox. JAMA. Published online May 5, 2023 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37145654 https://jamanetwork.com/journals/jama/fullarticle/2804849
- ↑ Centers for Disease Control & Prevention Monkeypox Vaccine Administration in the U.S. Data as of October 11 2022 https://www.cdc.gov/poxvirus/monkeypox/response/2022/vaccines_data.html