Evidence map›Paper›PMID 37336224›Full record

ArticleThe Lancet. Infectious diseases2023

Early evaluation of the safety, reactogenicity, and immune response after a single dose of modified vaccinia Ankara-Bavaria Nordic vaccine against mpox in children: a national outbreak response.

Shamez N Ladhani, Alexander C Dowell, Scott Jones, Bethany Hicks, Cathy Rowe, Jusnara Begum, Dagmar Wailblinger, John Wright, Stephen Owens, Ailsa Pickering and 17 more

Open access · hybridAbstract read
PubMed Publisher
In one paragraph

Article in The Lancet. Infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
5.5field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 39 citations in OpenAlex.

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  15. Mpox Virus as a Global Public Health Emergency: A Scoping Review.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

27 authors at 7 institutions in 1 country.

Shamez N LadhaniImmunisation Department, UK Health Security Agency, London, UK; Paediatric Infectious Diseases Research Group, St George's University of London, London, UK. Electronic address: shamez.ladhani@ukhsa.gov.uk.
Alexander C DowellInstitute of Immunology & Immunotherapy, University of Birmingham, Birmingham, UK.
Scott JonesEmerging Pathogen Serology, UK Health Security Agency, Porton Down, UK.
Bethany HicksEmerging Pathogen Serology, UK Health Security Agency, Porton Down, UK.
Cathy RoweEmerging Pathogen Serology, UK Health Security Agency, Porton Down, UK.
Jusnara BegumInstitute of Immunology & Immunotherapy, University of Birmingham, Birmingham, UK.
Dagmar WailblingerBradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
John WrightBradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
Stephen OwensPaediatric Immunology and Infectious Diseases, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Ailsa PickeringPaediatric Immunology and Infectious Diseases, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Benjamin ShilltoePaediatric Immunology and Infectious Diseases, Sheffield Children's NHS Foundation Trust, Sheffield, UK.
Paddy McMasterPaediatric Infectious Diseases, Manchester Foundation Trust, Manchester, UK.
Elizabeth WhittakerDepartment of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK; Section of Paediatric Infectious Diseases, Imperial College London, London, UK.
Jianmin ZuoInstitute of Immunology & Immunotherapy, University of Birmingham, Birmingham, UK.
Annabel PowellImmunisation Department, UK Health Security Agency, London, UK.
Gayatri AmirthalingamImmunisation Department, UK Health Security Agency, London, UK.
Sema MandalImmunisation Department, UK Health Security Agency, London, UK.
Jamie Lopez-BernalImmunisation Department, UK Health Security Agency, London, UK.
Mary E RamsayImmunisation Department, UK Health Security Agency, London, UK.
Neave KissanePaediatric Infectious Diseases Department, Evelina London Childrens' Hospital, London, UK.
Michael BellPaediatric Infectious Diseases Department, Evelina London Childrens' Hospital, London, UK.
Heather WatsonPaediatric Infectious Diseases Department, Evelina London Childrens' Hospital, London, UK.
David HoPaediatric Infectious Diseases Department, Evelina London Childrens' Hospital, London, UK.
Bassam HallisEmerging Pathogen Serology, UK Health Security Agency, Porton Down, UK.
Ashley OtterEmerging Pathogen Serology, UK Health Security Agency, Porton Down, UK.
Paul MossInstitute of Immunology & Immunotherapy, University of Birmingham, Birmingham, UK.
Jonathan CohenPaediatric Infectious Diseases Department, Evelina London Childrens' Hospital, London, UK.
UK Health Security Agency · GBEvelina London Children's Healthcare · GBUniversity of Birmingham · GBBradford Teaching Hospitals NHS Foundation Trust · GBNewcastle upon Tyne Hospitals NHS Foundation Trust · GBImperial College Healthcare NHS Trust · GBSheffield Children's NHS Foundation Trust · GB

Funding

Medical Research Council MC_PC_20031Medical Research Council MC_PC_20060
6 · The paper itself

Abstract

backgroundIn response to a national mpox (formerly known as monkeypox) outbreak in England, children exposed to a confirmed mpox case were offered modified vaccinia Ankara-Bavaria Nordic (MVA-BN), a third-generation smallpox vaccine, for post-exposure prophylaxis. We aimed to assess the safety and reactogenicity and humoral and cellular immune response, following the first reported use of MVA-BN in children.

methodsThis is an assessment of children receiving MVA-BN for post-exposure prophylaxis in response to a national mpox outbreak in England. All children receiving MVA-BN were asked to complete a post-vaccination questionnaire online and provide a blood sample 1 month and 3 months after vaccination. Outcome measures for the questionnaire included reactogenicity and adverse events after vaccination. Blood samples were tested for humoural, cellular, and cytokine responses and compared with unvaccinated paediatric controls who had never been exposed to mpox.

findingsBetween June 1 and Nov 30, 2022, 87 children had one MVA-BN dose and none developed any serious adverse events or developed mpox disease after vaccination. Post-vaccination reactogenicity questionnaires were completed by 45 (52%) of 87 children. Their median age was 5 years (IQR 5-9), 25 (56%) of 45 were male, and 22 (49%) of 45 were White. 16 (36%) reported no symptoms, 18 (40%) reported local reaction only, and 11 (24%) reported systemic symptoms with or without local reactions. Seven (8%) of 87 children provided a first blood sample a median of 6 weeks (IQR 6·0-6·5) after vaccination and five (6%) provided a second blood sample at a median of 15 weeks (14-15). All children had poxvirus IgG antibodies with titres well above the assay cutoff of OD

interpretationA single dose of MVA-BN for post-exposure prophylaxis was well-tolerated in children and induced robust antibody and cellular immune responses up to 15 weeks after vaccination. Larger studies are needed to fully assess the safety, immunogenicity, and effectiveness of MVA-BN in children. Our findings, however, support its on-going use to prevent mpox in children as part of an emergency public health response.

fundingUK Health Security Agency.

Indexed as

Mpox, MonkeypoxSmallpox VaccineVacciniaAntibodies, ViralAntigens, ViralChildChild, PreschoolDisease OutbreaksFemaleHumansImmunity, CellularMaleVaccinia virusAntibodies, ViralAntigens, ViralSmallpox Vaccine

Identifiers

PMID37336224
OpenAlexW4380985874

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.