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University of Nebraska Medical Center

Mpox outbreak was wake-up call for smallpox preparation, vaccine maker Bavarian Nordic says

CNBC

The maker of the mpox vaccine is looking at ways to dramatically scale up its production capacity to prepare for a potential threat from smallpox.

Bavarian Nordic CEO Paul Chaplin said the rapid spread of mpox last year was a wake-up call for the company, which is based in Denmark.

“If it wasn’t mpox but it was smallpox, we are completely at the wrong scale,” Chaplin told CNBC in an interview.

“We’re looking at ways we can dramatically change the way we manufacture to increase our scale,” he said.

Mpox is in the same virus family as smallpox. Bavarian Nordic’s Jynneos vaccine is approved by the U.S. Food and Drug Administration to protect against both pathogens.

Previously known as monkeypox, the World Health Organization changed the name to mpox last year to reduce stigma.

Bavarian Nordic plans to simplify its production process so it can easily partner with other manufacturers and scale up production capacity to hundreds of millions of doses in the event of an emergency.

The company’s current production capacity is tens of millions of doses.

Smallpox was eradicated from the world in 1980 after a successful global vaccination campaign. Though the risk of the virus returning is low, some governments don’t want to take any chances.

“There are concerns either through reengineering or accidental outbreaks from containment, or other terrorist activities that it could be reintroduced,” Chaplin said of smallpox. 

Smallpox was one of the most deadly diseases known to humankind. It had a mortality rate of up to 30% depending on the strain, according to the WHO.

In the wake of the mpox epidemic, the European Union’s Health Emergency Preparedness and Response Authority and at least two European national governments have shown interest in stockpiling the Jynneos vaccine for use against smallpox, Chaplin said. 

“Last year it was all about mpox. And now it’s a mixture of mpox, but also more strategic stockpiling, including the smallpox indication,” Chaplin said of discussions about future orders.

“The discussions have definitely intensified and increased,” he said.

The U.S. has a long-standing stockpile of more than 100 million doses of an older smallpox vaccine, called ACAM2000.

Bavarian Nordic will finish delivering an order of 5 million Jynneos doses for the U.S government in the first half of this year. That contract was signed during the mpox outbreak.

Mpox as a warning

Once limited mostly to Africa, mpox spread suddenly and rapidly around the world last summer, taking public health authorities and Bavarian Nordic by surprise.

Unlike smallpox, mpox is rarely lethal, but the virus can be deadly for people with severely compromised immune systems. And the skin lesions associated with the disease can cause excruciating pain.

Bavarian Nordic only had several thousand finished doses of Jynneos on hand when the United Kingdom reported the first known case of the epidemic to the WHO last May. 

“We sold the entire stock to the U.K. government, thinking that this was, as usual, an isolated case,” Chaplin said. 

Sporadic cases of mpox had occurred in countries outside Africa by travelers in the past. In 2003, there was a small outbreak in the U.S. that came from imported animals.

But when other countries in Europe started reporting cases of the virus last year, it became clear something unusual was happening, Chaplin said.

“The phone started ringing and we realized we were in a situation that we hadn’t seen before,” Chaplin said.

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