Vaccinating against monkeypox in the Democratic Republic of the Congo

Antiviral Res. 2019 Feb:162:171-177. doi: 10.1016/j.antiviral.2018.11.004. Epub 2018 Nov 14.


Healthcare-associated transmission of monkeypox has been observed on multiple occasions in areas where the disease is endemic. Data collected by the US Centers for Disease Control and Prevention (CDC) from an ongoing CDC-supported program of enhanced surveillance in the Tshuapa Province of the Democratic Republic of the Congo, where the annual incidence of human monkeypox is estimated to be 3.5-5/10,000, suggests that there is approximately one healthcare worker infection for every 100 confirmed monkeypox cases. Herein, we describe a study that commenced in February 2017, the intent of which is to evaluate the effectiveness, immunogenicity, and safety of a third-generation smallpox vaccine, IMVAMUNE®, in healthcare personnel at risk of monkeypox virus (MPXV) infection. We describe procedures for documenting exposures to monkeypox virus infection in study participants, and outline lessons learned that may be of relevance for studies of other investigational medical countermeasures in hard to reach, under-resourced populations.

Keywords: Clinical trial; Democratic Republic of the Congo; IMVAMUNE; Monkeypox; Smallpox vaccine.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Animals
  • Clinical Trials as Topic
  • Democratic Republic of the Congo / epidemiology
  • Health Personnel*
  • Health Resources
  • Humans
  • Immunogenicity, Vaccine
  • Monkeypox virus
  • Mpox (monkeypox) / epidemiology
  • Mpox (monkeypox) / prevention & control*
  • Occupational Diseases / epidemiology
  • Occupational Diseases / prevention & control*
  • Occupational Diseases / virology
  • Risk Factors
  • Rural Population
  • Smallpox Vaccine / administration & dosage*
  • Smallpox Vaccine / immunology
  • Vaccination
  • Vaccines, Attenuated / administration & dosage
  • Vaccines, Attenuated / immunology


  • Smallpox Vaccine
  • Vaccines, Attenuated
  • smallpox and monkeypox vaccine modified vaccinia ankara-bavarian nordic