Effect of childhood smallpox vaccination on clinical characteristics of adult mpox cases
Objective To compare the clinical features,epidemiological characteristics and laboratory testing results of mpox cases with or without smallpox vaccination in childhood,so as to explore the effect of smallpox vaccination in childhood on disease onset,clinical characteristics and laboratory testing results among confirmed mpox cases.Methods The confirmed cases of mpox who received smallpox vaccination in childhood in Beijing from May 2023 to August 2023 were enrolled in the vaccination group,and the cases in the same period who had no smallpox or mpox vaccination were enrolled in the unvaccinated group.The data were collected through epidemiological investigations,electronic medical record queries,and telephone follow-ups.The demographic information,disease onset and hospital visit,clinical features,epidemiological information and laboratory between the two groups were compared and analyzed.Results A total of 90 cases were included in this study,including 10 cases in the vaccinated group and 80 cases in the unvaccinated group.All cases were males.The mean age of patients in the vaccinated group was 47.50±5.06 years old,and that in the unvaccinated group was 31.68±5.34 years old.In the vaccination group,there were 9 men who have sex with men(MSM)and 6 were HIV-infected.In the unvaccinated group,there were 78 MSM and 43 HIV-infected patients.The differences in seeking for medical treatment,onset of disease,the time interval between onset and diagnosis,and having sexual behavior within the past 21 days between the vaccinated group and the unvaccinated group were not statistically significant(P＞0.05).The differences in clinical features,including fever,rash,site of rash and lymph node enlargement between the vaccinated group and the unvaccinated group were not statistically significant(P＞0.05).Among laboratory testing criteria,the difference in the positive of the throat swab between the vaccinated group and the unvaccinated group were statistically significant(P＜0.05).The differences in positive of the rash smear/scab and the Ct value distribution between the vaccinated group and the unvaccinated group were not statistically significant(P＞0.05).Conclusions Mpox can still develop even if the individual received smallpox vaccination at young age.There were no significant differences in clinical features and epidemiological characteristics between vaccinated and unvaccinated populations in confirmed mpox cases.In the subsequent development of mpox vaccine and vaccination protocol,the population who had been vaccinated against smallpox should not be ignored.
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