World Health Organization WHO recommends use of smallpox vaccines for monkeypox.
- Mass vaccination is not required nor recommended for monkeypox at this time.
- For contacts of cases, post-exposure prophylaxis (PEP) is recommended with an appropriate second- or third-generation vaccine, ideally within four days of first exposure to prevent onset of disease.
- Pre-exposure prophylaxis (PrEP) is recommended for health workers at risk, laboratory personnel working with orthopoxviruses, clinical laboratory staff performing diagnostic testing for monkeypox, and others who may be at risk as per national policy.
- Vaccination programmes must be backed by thorough surveillance and contact-tracing, and accompanied by a strong information campaign, robust pharmacovigilance, ideally in the context of collaborative vaccine effectiveness studies with standardized protocols and data collection tools.
- Decisions on use of smallpox or monkeypox vaccines should be based on a full assessment of risks and benefits on a case-by-case basis.
