The most important facts about vaccination against Mpox / "monkeypox"
- In the EU, the Vaccine Imvanex has been authorised for vaccination against Mpox. According to current knowledge, it is also effective against variant ("clade") 1b.
- Vaccination is recommended for people who Contact with the pathogen had (as post-exposure prophylaxis). As a preventive protective measure, it is Recommended for men who have sex with changing men.
- The vaccination offers a good protection before a Contagion with Mpox and a high protection before severe courses of disease.
- The vaccine is usually very well tolerated. However, insured persons often have to advance the costs and then have them reimbursed by the health insurance company.
- Also People with HIV can be vaccinated against Mpox / "monkeypox".
Who should be vaccinated against Mpox / "monkeypox"?
The Standing Committee on Vaccination (STIKO) recommends that certain groups of people from the age of from 18 years. It distinguishes between two different occasions for vaccination:
- after contact with the Mpox pathogen as so-called Post-exposure prophylaxis and
- before possible contact with the pathogen for people at increased risk.
1. subsequent vaccination (post-exposure prophylaxis)
A "subsequent vaccination" is particularly recommended
- to close physical contact via skin or mucous membranes with a person suffering from Mpox (e.g. during sex or when living together)
- after contact in the medical care without sufficient personal protective equipment
- to unprotected contact of laboratory personnel with non-inactivated Mpox material
The subsequent vaccination should as early as possible and in the period from up to 14 days after possible contact with the pathogen. It is only carried out if No symptoms are present. If symptoms are present, the body should not be further burdened by a vaccination. It can also be assumed that a vaccination at this stage can no longer mitigate the course of the disease.
2. Preventive vaccination
In Germany, infections with Mpox have so far been reported almost exclusively in Men who have sex with men (MSM). Vaccination is recommended for MSM with frequently changing partners in order to protect themselves from infection or a severe course of the disease.
There is also a vaccination recommendation for Laboratory staffthat has contact with infectious samples and is considered at risk of infection.
How is vaccination against Mpox / "monkeypox" carried out?
The vaccine is usually administered under the skin on the upper arm (subcutaneous injection). The number of vaccine doses may vary:
- Persons who are still not vaccinated against smallpox receive two doses of vaccine at least 28 days apart.
- For persons who have already violated the vaccinated against true smallpox (variola) one dose of vaccine is sufficient.
- People with HIV can also be immunised. However, they should always receive two doses of vaccine, even if they have been immunised against true smallpox in the past.
Is the vaccination safe?
Yes, the vaccine recommended by the STIKO, Imvanex, contains an attenuated form of a virus that can cause No illness and cannot multiply in human cells. The tolerability of the vaccine was tested on over 2000 people from different age groups, with different genders and with and without HIV prior to European authorisation. The vaccine can be considered safe.
What are the side effects of the vaccination against Mpox / "monkeypox"?
Very common side effects (in more than 10 per cent of vaccinated people) are Headache, nausea, muscle pain and reactions at the injection site. The vaccination reactions usually subside after just a few days.
When does the vaccine take effect?
Already about two weeks After the first dose of vaccine, the risk of contracting the disease is significantly reduced. For basic immunisation, a second vaccination dose should then be given at intervals of at least 28 days and a maximum of two years. If a person has already been vaccinated against true smallpox in the past, one vaccination dose is usually sufficient for a booster.
Important: The vaccination significantly reduces the risk of infection and a severe course (up to 89 per cent), but does not offer 100 per cent protection. It is therefore also important other measures to reduce the risk.
What is the protective effect of the vaccination against Mpox / "monkeypox"?
This means that the probability of contracting the disease for vaccinated people is around 76 and 82 per cent lower than for unvaccinated. However, this does not mean that 13 or 11 per cent of vaccinated people will fall ill, and not all unvaccinated people will fall ill either.
Conclusion
- Vaccination significantly reduces the risk of infection and a severe course, but does not offer 100 per cent protection. It is therefore also important other measures to reduce the risk.
Is the Mpox vaccination also effective against the new variant ("clade") 1b?
Yes, that Robert Koch Institute assumesthat the vaccination against Mpox also protects against the new variant 1b.
How long does the vaccination against Mpox last?
In principle, vaccination against Mpox consists of two doses at least 28 days apart. Although a certain level of protection is already in place around two weeks after the first dose, the second dose is important to ensure that the protection lasts for a long time. It is assumed that vaccination protection starts to wear off after around two years after just one dose. So anyone who has only had one dose and wants to complete their immunisation should seek advice.
According to the Standing Vaccination Commission, people who were vaccinated against smallpox in childhood generally only need one dose of vaccine to refresh their protection against Mpox. Only people with immunodeficiency are recommended to be vaccinated with two doses.
According to the RKI, anyone who has had Mpox does not need a vaccination because, according to current knowledge, they have immune protection for several years after the illness.
Am I protected if I have already been vaccinated against true smallpox (variola)?
The vaccination against true smallpox (variola), the until 1976 in the FRG and until 1982 in the GDR according to the RKI, also offers protection against Mpox ("monkeypox"). Nevertheless, a subsequent vaccination after contact with the pathogen (post-exposure prophylaxis) or a preventive vaccination is recommended for people who have previously been vaccinated against smallpox. In this case, however, one dose of vaccine is usually sufficient instead of two.
Should I also get vaccinated if I have already had Mpox / "monkeypox"?
No. As far as we know, the immune protection built up by the disease is sufficient. several years to protect against further infection.
Is the vaccination against Mpox free of charge for me?
The statutory health insurance funds cover the costs for insured persons for whom the STIKO vaccination recommendation applies (especially men who have sex with men and frequently change partners). Also private health insurance companies often cover the costs. However, this should be clarified with the insurance company in advance. You often have to pay for the vaccination privately in advance. However, the costs are usually reimbursed after submission to the health insurance company.
Where can I get vaccinated against Mpox / "monkeypox"?
Where people can be vaccinated is regulated differently in the individual federal states. We have researched publicly available information and the relevant associations of statutory health insurance physicians and update the information regularly. (Last update: 31 October 2024)
The Mpox vaccination is part of the Vaccination guideline. It is available to people with statutory health insurance who are at increased risk, including men over the age of 18 who have sex with men (MSM) and frequently change partners. In other words: Doctors in the so-called statutory health insurance scheme ("Kassenärzt*innen") can prescribe the Mpox vaccination if there is an indication. Whether private health insurance companies also cover the vaccination should be enquired with the respective insurance company.
Vaccination in medical practice
The way to get vaccinated by a statutory health insurance doctor depends primarily on whether there is a so-called "vaccination programme" in the federal state in which you live. Vaccination agreement between the health insurance funds and the responsible Association of Statutory Health Insurance Physicians. The vaccination agreement regulates how the vaccination is carried out and what costs may be charged.
Mpox vaccination in federal states with Mpox vaccination agreement
In the federal states in which there is an Mpox vaccination agreement, people with statutory health insurance can be vaccinated by panel doctors - all they need to do is present their health card and the costs do not have to be advanced.
Federal states in which, according to our research, there is an Mpox vaccination agreement (as of 04.12.2024):
- Baden-Württemberg (Source)
- Bavaria (Source)
- Berlin (Source)
- HamburgSpecial case. Although there is no vaccination agreement in accordance with the vaccination guideline, there is an agreement to carry out the vaccination; vaccination is free of charge and also for uninsured people, apparently from the remaining stocks of the federal government from the procurement carried out in 2022, which are distributed by the social welfare authority. The social welfare authorities and the Hamburg Association of Statutory Health Insurance Physicians have agreed to initially only supply the HIV-focussed practices that are most frequently confronted with this virus. Those eligible for vaccination can contact one of the https://www.kvhh.net/de/praxis/aktuelle-meldungen/mpox-affenpockenvirus-who-ruft-weltweite-notlage-aus.html contact the practices mentioned; information from the Association of Statutory Health Insurance Physicians from 23.8.2024
- Hesse (Source)
- North Rhine-Westphalia (Associations of Statutory Health Insurance Physicians North Rhine [Source] and Westphalia-Lippe [Source])
- Rhineland-Palatinate (Source(Information from the Association of Statutory Health Insurance Physicians dated 23 August)
- Saarland (Source)
- Saxony-AnhaltSpecial case. Although there is no vaccination agreement in accordance with the vaccination guideline, there is an agreement to carry out the vaccination; vaccination is free of charge and apparently also for uninsured people from the remaining stocks of the federal government from the procurement carried out in 2022. HIV focus practices, university clinics and other practices are involved in the vaccination (information from the Ministry of Labour, Social Affairs, Health and Equality of Saxony-Anhalt from 11/09/2024
- Schleswig-Holstein (Source)
Mpox vaccination in Federal states without Mpox vaccination agreement
There is still no vaccination agreement in most federal states (as of 8 October 2024). In these states, people with statutory health insurance who are entitled to the Mpox vaccination must advance the costs of the vaccine and the vaccination and then submit an application for reimbursement to their health insurance provider. According to the vaccination recommendation, two doses should generally be given at least 28 days apart. You should expect to pay at least 200 euros per dose for the vaccine alone. In addition, there are the medical costs for counselling and information as well as each of the vaccinations (around 10 euros each) and possibly the costs for shipping the vaccine.
Federal states in which, according to our research no Mpox vaccination agreement exists (as at 04.12.2024):
- Brandenburg (Source; telephone information from the Association of Statutory Health Insurance Physicians on 23 August; according to "Tagesspiegel" from 28/09/2024 Mpox will not be included in the vaccination agreement due to very low demand)
- Bremen (Source)
- Mecklenburg-Western Pomerania (Source: telephone information from the KV, Department 2 Contracts, dated 23 August)
- Lower Saxony (Source: Information from the KV from 23 August)
- Saxony (Source; telephone information from the KV on 23 August; vaccination options: https://www.gesunde.sachsen.de/affenpocken-4658.html)
- Thuringia (Source(Information from the KV Thuringia by e-mail dated 26 August)
Further vaccination options
Some health authorities also vaccinate against Mpox.
In some cities, uninsured people can also be vaccinated (in Berlin, for example, the centres for sexual health and family planning offer this option).
Information is provided by the AIDS service organisations and the local health authorities. Addresses and contact details of local health authorities can be found using the RKI search tool: https://tools.rki.de/PLZTool/.
Ordering the vaccine
Every pharmacy in Germany can order the Mpox vaccine from a specialised pharmaceutical wholesaler. Information can be obtained from the manufacturer of the vaccine at customerservice@bavarian-nordic.com or +49 89 255 446 300.
