Introduction
As the world continues to grapple with public health challenges, monkeypox (MPOX) has emerged as a concern, albeit one with significantly less impact than other global health crises. Despite the high survival rate and declining incidence of the disease, there has been substantial investment in vaccines and a heightened level of public attention. This article aims to contextualize the actual risks posed by monkeypox against the backdrop of the response it has elicited, particularly in terms of vaccination efforts.
Survival Rate and Global Prevalence
Globally, the survival rate for individuals infected with monkeypox is extraordinarily high. Since 2022, there have been 80,850 documented cases, with a total of 55 deaths. This equates to a survival rate of 99.942%, highlighting the relatively low fatality risk associated with the virus. Moreover, no significant comorbidities, geographic locations, or socioeconomic factors have been identified that could disproportionately influence survival rates.1
As of 2024, the global prevalence of monkeypox has markedly declined. The highest single-day report of infections was 64 cases globally. By the latter half of July 2024, the daily global prevalence rate had fallen to between 3 and 8 cases. This sharp decrease indicates that the monkeypox outbreak is no longer a significant global health threat, contrary to some public perceptions.2
The Vaccine Response: JYNNEOS
In response to the 2022 monkeypox outbreak, the U.S. government has invested $157 million in purchasing the JYNNEOS vaccine, manufactured by Bavarian Nordic, a Danish pharmaceutical company. This vaccine is one of only five products that the company markets, making it a critical focus of their operations.3 JYNNEOS, a non-replicating live vaccine, has been approved for the prevention of both smallpox and monkeypox in adults at high risk of infection.4
Known Side Effects
The JYNNEOS vaccine, while widely regarded as safe, has several documented side effects. In clinical trials, common side effects included injection site reactions such as pain (84.9%), redness (60.8%), and swelling (51.6%). Systemic reactions were also reported, including muscle pain (42.8%), headache (34.8%), and fatigue (30.4%).5 More concerning, however, are the serious adverse events associated with the vaccine. These include a 2.3% incidence rate of severe autoimmune responses such as Crohn's disease and sarcoidosis. Additionally, there is a 1.3% rate of cardiac adverse events, including myocarditis and pericarditis, leading to a total of 3.6% of vaccine recipients experiencing serious adverse effects.6
Risk-Benefit Analysis
Given the extremely high survival rate of monkeypox and the low current prevalence of the disease, the aggressive push for widespread vaccination, particularly with a vaccine that has a non-negligible rate of serious adverse events, warrants scrutiny. The decision to vaccinate should involve a careful evaluation of the risk-benefit ratio, especially considering that the vast majority of those infected with monkeypox recover without severe complications.7
Contextualizing the Public Response
The response to monkeypox, particularly the push for mass vaccination, appears disproportionate when compared to the actual risks posed by the virus. The catastrophic framing of monkeypox as a major public health threat may not align with the data, which suggests that the virus (if we are to believe conventional narratives around viral contagion) has a very low mortality rate and that the incidence of new cases is declining globally. This discrepancy raises questions about the motivations behind the public health response and the potential overemphasis on vaccination in a context where the risk of severe outcomes is minimal.8
Conclusion
Given the broader context, it appears monkeypox does not pose a significant threat to global health relative to other well characterized ones. The investment in and focus on vaccination, particularly with a vaccine that carries its own risks, should be carefully considered against the backdrop of the virus's low fatality rate and declining prevalence. A balanced approach that prioritizes informed decision-making and contextualized risk assessment is crucial as we navigate the ongoing response to monkeypox.
### References
1: Ranjit Sah et al., "Monkeypox (Mpox) Vaccines and Their Side Effects: The Other Side of the Coin," *International Journal of Surgery*, February 2023, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10389550/.
2: Edouard Mathieu et al., "Mpox," *Our World in Data*, July 2024, https://ourworldindata.org/mpox.
3: Fraiser Kansteiner, "Bavarian Nordic Scores $157M Contract to Replenish US Supplies of Smallpox/Mpox Vaccine Jynneos," *Fierce Pharma*, August 2024, https://fiercepharma.com/pharma/bavarian-nordic-scores-1568m-contract-replenish-us-supplies-combination-smallpoxmpox-vaccine-jynneos.
4: "JYNNEOS Package Insert," *U.S. Food and Drug Administration*, accessed August 2024, https://www.fda.gov/media/131078/download.
5: "JYNNEOS Package Insert," *U.S. Food and Drug Administration*.
6: Ibid.
7: Sah et al., "Monkeypox (Mpox) Vaccines and Their Side Effects."
8: Mathieu et al., "Mpox."
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