Orthopoxvirus Vaccine Guidance for Persons at Risk for Occupational Exposure
On November 3, 2021, the Advisory Committee and Immunization Practices (ACIP) voted to recommend vaccination for select persons at risk for occupational exposure to orthopoxviruses. Such persons include:
- Research laboratory personnel1, clinical laboratory personnel performing diagnostic testing for orthopoxviruses2, and for designated response team members at risk for occupational exposure to orthopoxviruses3.
- Healthcare personnel who administer ACAM2000 or care for patients infected with replication competent orthopoxviruses based on shared clinical decision-making4.
Persons who are at continued risk5 for occupational exposure to more virulent orthopoxviruses like variola virus or monkeypox virus should receive booster doses of JYNNEOS every 2 years after the primary JYNNEOS series. Persons who are at continued risk5 for occupational exposure to replication competent orthopoxviruses like vaccinia virus or cowpox virus should receive booster doses of JYNNEOS at least every 10 years after the primary JYNNEOS series. Persons who are at continued risk5 for occupational exposure to orthopoxviruses, and who received an ACAM2000 primary vaccination, should receive a booster dose of JYNNEOS as an alternative to a booster dose of ACAM2000.
Additional ACIP recommendations are available here.
Two orthopoxvirus vaccines are available from CDC Drug Service for persons at risk for occupational exposure.
- JYNNEOS is a live, non-replicating vaccine licensed by the U.S. Federal Drug Administration (FDA) for prevention of smallpox and monkeypox disease in adults 18 years of age and older determined to be at high risk for smallpox or monkeypox infection.
- ACAM2000 is a live vaccine for active immunization against smallpox disease licensed by the U.S. FDA for persons determined to be at high risk for smallpox infection.
Requests for vaccine, including the reason for the request, should be referred to the CDC Emergency Operations Center at 770-488-7100.
1 Research laboratory personnel are those who directly handle 1) cultures or 2) animals contaminated or infected with replication-competent vaccinia virus, recombinant vaccinia viruses derived from replication-competent vaccinia strains (i.e., those that are capable of causing clinical infection and producing infectious virus in humans), or other orthopoxviruses that infect humans (e.g., monkeypox, cowpox, and variola).
2 Clinical laboratory personnel who perform routine chemistry, hematology, and urinalysis testing, including for suspected or confirmed patients with orthopoxvirus infections, are not included in this recommendation as their risk for exposure is very low.
3 Public health authorities, at their own discretion, may approve a cohort of healthcare and/or public health personnel to receive primary vaccination against orthopoxviruses for preparedness purposes (e.g., first responders who might participate in a smallpox or monkeypox outbreak).
4 For example, those caring for patients enrolled in clinical trials for replication-competent orthopoxvirus vaccines and those caring for persons with suspected or confirmed orthopoxvirus infections (e.g., clinicians and environmental services personnel).
5 Continued risk refers to persistent risk due to occupational work performed. Designated public health and healthcare worker response teams approved by public health authorities are not at “continued risk” because they are vaccinated for the purposes of preparedness.