Current and emerging Mpox vaccine strategies: A comprehensive review

Abstract

Monkeypox virus (MPXV), a zoonotic orthopoxvirus closely related to variola virus, is a double-stranded DNA (dsDNA) virus in the Orthopoxvirus genus, which includes vaccinia and cowpox viruses. Identified in 1958 and first documented in humans in 1970, MPXV poses substantial public health challenges. Its origins remain uncertain, but African rodents like fire-footed rope squirrels and non-human primates are potential reservoirs. Recent global outbreaks have highlighted the urgent need for effective vaccination strategies to mitigate morbidity, mortality, and transmission risks. Approved vaccines such as ACAM2000 and MVA-BN demonstrate efficacy in preventing MPXV infection, with MVA-BN offering a safer profile, particularly for immunocompromised individuals. Emerging platforms, including mRNA and multivalent vaccines, show promise in enhancing immune responses and addressing limitations of traditional vaccines. Preclinical studies highlight significant advancements in rapid-deployment technologies, enabling robust humoral and cellular immunity against MPXV. Current vaccination strategies against MPXV provide foundational tools for outbreak control; however, gaps remain in accessibility, safety, and scalability. Equitable vaccine distribution and investment in research are essential to address the global mpox threat effectively.

Keywords: Immunization strategies; Jynneos; MPXV; Monkeypox virus; Mpox; Orthopoxvirus; Public health; Vaccination strategies; Vaccine development; Variola virus; mRNA vaccines.