Low levels of monkeypox virus neutralizing antibodies after MVA-BN vaccination in healthy individuals

Luca M Zaeck, Mart M Lamers, Babs E Verstrepen, Theo M Bestebroer, Martin E van Royen, Hannelore Götz, Marc C Shamier, Leanne P M van Leeuwen, Katharina S Schmitz, Kimberley Alblas, Suzanne van Efferen, Susanne Bogers, Sandra Scherbeijn, Guus F Rimmelzwaan, Eric C M van Gorp, Marion P G Koopmans, Bart L Haagmans, Corine H GeurtsvanKessel, Rory D de Vries

Research output: Contribution to journalArticleAcademicpeer-review

105 Citations (Scopus)
38 Downloads (Pure)


In July 2022, the ongoing monkeypox (MPX) outbreak was declared a public health emergency of international concern. Modified vaccinia Ankara—Bavarian Nordic (MVA-BN, also known as Imvamune, JYNNEOS or Imvanex) is a third-generation smallpox vaccine that is authorized and in use as a vaccine against MPX. To date, there are no data showing MPX virus (MPXV)-neutralizing antibodies in vaccinated individuals nor vaccine efficacy against MPX. Here we show that MPXV-neutralizing antibodies can be detected after MPXV infection and after historic smallpox vaccination. However, a two-shot MVA-BN immunization series in non-primed individuals yields relatively low levels of MPXV-neutralizing antibodies. Dose-sparing of an MVA-based influenza vaccine leads to lower MPXV-neutralizing antibody levels, whereas a third vaccination with the same MVA-based vaccine significantly boosts the antibody response. As the role of MPXV-neutralizing antibodies as a correlate of protection against disease and transmissibility is currently unclear, we conclude that cohort studies following vaccinated individuals are necessary to assess vaccine efficacy in at-risk populations.

Original languageEnglish
Pages (from-to)270-278
Number of pages9
JournalNature Medicine
Issue number1
Early online date18 Oct 2022
Publication statusPublished - Jan 2023

Bibliographical note

Funding Information:
We acknowledge Bas Oude Munnink for sequence analysis of the MPXV clinical material. This work was partially funded by the European Union’s Horizon 2020 Grant for ECRAID-Base (grant agreement no. 965313; awarded to M.P.G.K.), in preparation for possible clinical studies and trials after the decision to activate Ecraid to outbreak mode 2. The sequencing work was supported by the European Union’s Horizon 2020 Grant VEO (grant no. 874735 awarded to M.P.G.K.). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

Publisher Copyright:
© 2022, The Author(s).


Dive into the research topics of 'Low levels of monkeypox virus neutralizing antibodies after MVA-BN vaccination in healthy individuals'. Together they form a unique fingerprint.

Cite this