Monkeypox Vaccine: Efficacy and Injection Methods Explained

Questions related to the monkeypox vaccine?

Hello, Doctor.
I would like to ask two questions related to the monkeypox vaccine:
1.
After receiving the vaccine, does it completely prevent infection, or does it significantly reduce the likelihood of infection (I've heard that receiving two doses can provide nearly 90% protection)? Or does it primarily reduce the severity of symptoms (similar to how COVID-19 vaccines can still lead to infection but result in milder cases)? Or is it a combination of both? I'm unclear about the actual "effectiveness" of the monkeypox vaccine, and I hope you can help clarify this.
2.
What is the difference between subcutaneous and intradermal administration? I found online that the efficacy of both methods is quite similar, which makes it hard for me to understand the distinction.
Do you have a preferred method of administration? Due to my lifestyle, I am currently considering getting the monkeypox vaccine, and I hope you can help clarify my doubts.
Thank you, Doctor!

gc, 20~29 year old female. Ask Date: 2023/07/07

Dr. Ye Qianyu reply Family Medicine

Hello! 1.
"According to preliminary literature from abroad, high-risk contacts should receive vaccination within 14 days after the last exposure, with vaccine efficacy reaching approximately 80%.
Vaccination within 4 days after the last exposure can achieve optimal preventive effects.
If vaccinated between 4 to 14 days post-exposure, it may not prevent disease onset but can reduce the severity of the illness.
The monkeypox vaccine provides partial protection after the first dose, and peak immunity is reached 14 days after the second dose.
However, due to limited experience with its use, the vaccine's effectiveness against the current circulating strain and the duration of antibody response remain unclear.
Therefore, even after vaccination, individuals should continue to implement various preventive measures to protect themselves and avoid close skin contact (including intimate contact such as sexual contact) with monkeypox patients." 2.
"Clinical trial literature from abroad indicates that there is no significant difference in immunity between intradermal and subcutaneous injection.
The difference lies in that intradermal injection requires a smaller dosage, but it necessitates injection technique, which may lead to larger local skin reactions, such as redness and swelling, requiring post-injection care.
Individuals with keloid tendencies, immunocompromised conditions, or those under 18 years of age should proactively communicate with their physician to adjust to subcutaneous injection."

Reply Date: 2023/07/07

More Info

The monkeypox vaccine is an important tool in controlling the spread of the virus, especially in high-risk populations. Let's address your questions regarding its efficacy and the methods of administration.

1. Efficacy of the Monkeypox Vaccine: The monkeypox vaccine does not guarantee complete immunity against infection. However, studies indicate that it can significantly reduce the risk of contracting the virus. According to preliminary data, the vaccine can provide about 80% protection when administered within 14 days of exposure to the virus. If the vaccine is given within four days of exposure, the protective effect is even greater.
It's important to note that while the vaccine can reduce the likelihood of infection, it may not completely prevent it. In cases where vaccinated individuals do contract monkeypox, the vaccine has been shown to lessen the severity of the disease, similar to how COVID-19 vaccines work. This means that vaccinated individuals may experience milder symptoms compared to those who are unvaccinated. Therefore, the vaccine offers both a reduction in the risk of infection and a decrease in the severity of symptoms if infection occurs.
Given the current understanding, it is advisable for individuals, especially those at higher risk, to continue practicing preventive measures even after vaccination. This includes avoiding close contact with confirmed monkeypox cases and maintaining good hygiene practices.

2. Differences Between Subcutaneous and Intradermal Injection: The method of vaccine administration can influence the immune response. Subcutaneous injections deliver the vaccine into the fatty tissue just beneath the skin, while intradermal injections place the vaccine into the dermis, the layer of skin just below the outer layer.
Research indicates that both methods can elicit similar immune responses, but there are some differences. Intradermal injections typically require a smaller volume of the vaccine and may result in a more localized immune response. However, they also require a higher level of technical skill to administer correctly, and patients may experience more localized reactions, such as redness or swelling at the injection site.

For individuals with specific conditions, such as a history of keloids or those who are immunocompromised, subcutaneous injections may be preferred. Ultimately, the choice between these two methods should be made in consultation with a healthcare provider, who can assess individual health needs and preferences.

In conclusion, the monkeypox vaccine is a valuable tool in reducing the risk of infection and the severity of disease. While it does not provide absolute immunity, it significantly enhances protection, especially when combined with other preventive measures. The choice of injection method should be tailored to the individual, considering both efficacy and potential side effects. If you are considering vaccination due to your lifestyle, it is advisable to discuss your options with a healthcare professional who can provide personalized guidance based on your health status and risk factors.

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