Once again, an invisible pathogen is spreading at breakneck speed and making people sick. Many draw parallels to Corona when it comes to monkeypox. But do we need vaccination here too? What experts say.

If you have a scar on your upper arm, you’re lucky. He was probably vaccinated against smallpox in the 1960s and 1970s, when smallpox vaccination was still compulsory in both parts of Germany. This probably protects him from contracting monkeypox.

But in 1980, the World Health Organization (WHO) declared smallpox eradicated worldwide after an unprecedented vaccination campaign. In the Federal Republic of Germany, the obligation for an initial vaccination against smallpox was lifted in 1976, in the GDR in 1982. Younger people were generally no longer vaccinated.

Does this mean that if you are too young to have been vaccinated against smallpox, you still need to get vaccinated now? Or will the great vaccine search follow again, as we already know from Corona?

First of all, there is no vaccine approved against monkeypox in Europe. However, experts assume that conventional smallpox vaccines offer some protection.

They differentiate between an older smallpox vaccine and a modern one:

1. The “old” smallpox vaccine”

The federal government has stored about 100 million doses of smallpox vaccine, according to a report for the Bundestag health committee. However, due to the expected side effects, this vaccine is not suitable for use against monkeypox, said Federal Health Minister Karl Lauterbach.

“The older smallpox vaccine has many side effects, and it also contains reproductive viruses that could spread in the body of immunocompromised people,” explained Stefan Kaufmann, Director Emeritus at the Max Planck Institute for Infection Biology in Berlin.

The vaccine was stored more than ten years ago for fear of a planned smallpox attack. Due to its strong side effects, however, it is not suitable for the treatment or prophylaxis of monkeypox.

2. The “new” smallpox vaccine

There is also a newer smallpox vaccine based on a further development by the German microbiologist Anton Mayr in the 1960s: a vaccine virus weakened in the laboratory is used to generate an immune response against smallpox. Experts speak briefly of an MVA vaccination (MVA: Modified Vaccinia Virus Ankara).

“This vaccine was used for a time in the 1960s, but never on a large scale. It is better tolerated, the virus can no longer reproduce,” said Herwig Kollaritsch, who is a member of the Austrian counterpart to the Standing Vaccination Commission (Stiko). There is also no vaccination scar. With the vaccine, he sees the problem of a fairly uncertain vaccination effectiveness in practice in view of the eradicated disease. “But one can assume protection with a probability bordering on certainty.”

The MVA vaccine approved for adults against smallpox in the European Union (EU) since 2013 is called Imvanex and comes from the German-Danish company Bavarian Nordic. It is already approved for monkeypox in the United States. The WHO recently pointed out that it is not universally available. British health authorities have recently given more than 1,000 doses of it to contacts of monkeypox infected people, according to the UK Health Security Agency.

Germany is also making provisions for the event that such so-called ring vaccinations should become necessary in the event of contact with the sick: Lauterbach announced on Tuesday that up to 40,000 doses of Imvanex would be ordered prophylactically. There are no concrete plans to use this as yet. “We could use this vaccine immediately if it became necessary,” said Lauterbach.

However, the vaccine is not administered across the board. This means that not everyone now has to be vaccinated against monkeypox or smallpox. Expert Kollaritsch, for example, sees the newer vaccine as a tool to vaccinate people who are at high risk of being exposed to the pathogen. As an example, he cites the staff of special isolation wards that care for infected people. “For the general public, this vaccination would be nonsense. Monkeypox is much more harmless than smallpox and of much lesser importance in terms of epidemiological infection. We also have to keep in mind that very good therapy is available for those who are infected.”

The Viennese virologist Norbert Nowotny also emphasized: “There is a huge difference between monkeypox and Corona. It won’t be a pandemic this time. I assume that the spook will be over in a few weeks to a few months.” The pathogen that causes monkeypox is a DNA virus – that means it is much more sluggish than Sars-CoV-2 and hardly mutates. Variants will therefore not be seen so quickly. Nor does he assume that vaccines need to be specially adapted for monkeypox.

The head of the Standing Vaccination Commission (Stiko), Thomas Mertens, has a similar view. He recently said on the “Südwestrundfunk” (SWR): “I don’t think it makes sense to think about vaccinating the entire population against smallpox at the moment.”