Case study: breakthrough mpox infection in Aotearoa New Zealand and Australia after completed two-dose course of subcutaneous modified vaccinia Ankara (MVA-BN) vaccines

Vincent J. Cornelisse; John J. M. Kearley; Jose Vargas Castillo; Lindsay Macharg; Virginia A. McLaughlin; Susan J. Jack; Caitlin Swift

doi:10.1071/SH23139

RESEARCH ARTICLE (Open Access)

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Case study: breakthrough mpox infection in Aotearoa New Zealand and Australia after completed two-dose course of subcutaneous modified vaccinia Ankara (MVA-BN) vaccines

Vincent J. Cornelisse

^A ^B ^C ^* , John J. M. Kearley ^A , Jose Vargas Castillo ^A , Lindsay Macharg ^D , Virginia A. McLaughlin ^E , Susan J. Jack ^E and Caitlin Swift ^F

+ Author Affiliations

- Author Affiliations

^A Kirketon Road Centre, NSW Health, Sydney, NSW, Australia.

^B The Kirby Institute, University of NSW, Sydney, NSW, Australia.

^C Monash University, Melbourne, Vic., Australia.

^D Queenstown Medical Centre, Queenstown, Aotearoa, New Zealand.

^E Te Whatu Ora Southern, National Public Health Service, Aotearoa, New Zealand.

^F Public Health Unit, South Eastern Sydney Local Health District, Sydney, NSW, Australia.

^* Correspondence to: Vincent.Cornelisse1@monash.edu

Handling Editor: Darren Russell

Sexual Health - https://doi.org/10.1071/SH23139
Submitted: 28 July 2023 Accepted: 25 September 2023 Published online: 19 October 2023

Abstract

Background

In August 2022, in response to a global mpox outbreak, the World Health Organization recommended the Vaccinia vaccination for at-risk people.

Methods

Case study.

Results

We describe a case of a HIV-negative bisexual man who developed a symptomatic mpox infection 13 weeks after completing a two-dose course of subcutaneous third-generation modified vaccinia Ankara vaccines. The case likely acquired his mpox infection in the USA; was diagnosed in Aotearoa, New Zealand; and was followed-up in Australia, as he was actively travelling during his infection.

Conclusions

This case highlights the importance of maintaining clinical suspicion for mpox in people who present with consistent symptoms, even if they are fully vaccinated. Also, as he travelled around Aotearoa, New Zealand, and Australia during his infection, this case highlights how public health authorities and clinicians can cooperate across jurisdictional boundaries to support cases and minimise the risk of onward transmission.

Keywords: disease outbreaks, homosexuality, imvamune, male, monkeypox, orthopoxvirus, smallpox, tecovirimat, vaccination, vaccinia.

References

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