Vaccine Effectiveness of JYNNEOS against Mpox Disease in the United States

Details

• Alternative Title:
  N Engl J Med
• Personal Author:
  Deputy, Nicholas P. ; Deckert, Joseph ; Chard, Anna N. ; Sandberg, Neil ; Moulia, Danielle L. ; Barkley, Eric ; Dalton, Alexandra F. ; Sweet, Cory ; Cohn, Amanda C. ; Little, David R. ; Cohen, Adam L. ; Sandmann, Danessa ; Payne, Daniel C. ; Gerhart, Jacqueline L. ; Feldstein, Leora R.
• Description:
  BACKGROUND
  
  In the United States, more than 30,000 cases of mpox (formerly known as monkeypox) had occurred as of March 1, 2023, in an outbreak disproportionately affecting transgender persons and gay, bisexual, and other men who have sex with men. In 2019, the JYNNEOS vaccine was approved for subcutaneous administration (0.5 ml per dose) to prevent mpox infection. On August 9, 2022, an emergency use authorization was issued for intradermal administration (0.1 ml per dose); however, real-world effectiveness data are limited for either route.
  
  METHODS
  
  We conducted a case–control study based on data from Cosmos, a nationwide Epic electronic health record (EHR) database, to assess the effectiveness of JYNNEOS vaccination in preventing medically attended mpox disease among adults. Case patients had an mpox diagnosis code or positive orthopoxvirus or mpox virus laboratory result, and control patients had an incident diagnosis of human immunodeficiency virus (HIV) infection or a new or refill order for preexposure prophylaxis against HIV infection between August 15, 2022, and November 19, 2022. Odds ratios and 95% confidence intervals were estimated from conditional logistic-regression models, adjusted for confounders; vaccine effectiveness was calculated as (1 – odds ratio for vaccination in case patients vs. controls) × 100.
  
  RESULTS
  
  Among 2193 case patients and 8319 control patients, 25 case patients and 335 control patients received two doses (full vaccination), among whom the estimated adjusted vaccine effectiveness was 66.0% (95% confidence interval [CI], 47.4 to 78.1), and 146 case patients and 1000 control patients received one dose (partial vaccination), among whom the estimated adjusted vaccine effectiveness was 35.8% (95% CI, 22.1 to 47.1).
  
  CONCLUSIONS
  
  In this study using nationwide EHR data, patients with mpox were less likely to have received one or two doses of JYNNEOS vaccine than control patients. The findings suggest that JYNNEOS vaccine was effective in preventing mpox disease, and a two-dose series appeared to provide better protection. (Funded by the Centers for Disease Control and Prevention and Epic Research.)
  
  
• Subjects:
  Adult Case-Control Studies HIV Infections Homosexuality, Male Humans Male Mpox (monkeypox) Sexual And Gender Minorities United States Vaccine Efficacy
• Source:
  N Engl J Med. 388(26):2434-2443
• Pubmed ID:
  37199451
• Pubmed Central ID:
  PMC10962869
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  388
• Issue:
  26
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:49157431d82986dfc97fd9ae1b1bc4a8724e54a49757728c2104cb602c2bec340fe18a27aa15055b132bed8ba1dbe71571e853f4df0ffe4d293e3f67cc9f0e7f
• Download URL:
  https://stacks.cdc.gov/view/cdc/153547/cdc_153547_DS1.pdf
• File Type:
  [PDF - 474.89 KB ]