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Guidance

Smallpox and mpox: the green book, chapter 29

Smallpox and mpox immunisation information for public health professionals.

Updates to this page

From:
UK Health Security Agency
Published:
20 March 2013
Last updated:
11 June 2025
Show all updates

  1. Updated with changes to contacts eligible for post exposure vaccination following decision in April 2025 that all clades of mpox no longer met the criteria for a high consequence infectious disease (HCID).

  2. Amendment to post-exposure recommended use to include those previously primed with a live smallpox vaccine (in addition to those who have had one dose of MVA-BN) vaccine.

  3. Updated epidemiology following clade I cases in UK and clarification of advice in the event of a failed intradermal administration.

  4. Major update to include information on recent increase in clade I MPXV, new information on vaccine effectiveness and advice on outbreak response.

  5. Updated to include information on prioritising second doses.

  6. Added the option to use the deltoid area for intradermal administration of the vaccine.

  7. Corrected minor error in table.

  8. Updated to include information on intradermal vaccination and further clarification on the prioritisation during supply constraints.

  9. Revised to include advice on deferral of vaccination in recent cases, information on using IM administration, and change to definition of vulnerable children.

  10. Revised to include information on the new smallpox (MVA) vaccine and the response to cases of monkeypox.

  11. First published.

Documents

Smallpox and mpox: the green book, chapter 29

PDF, 271 KB, 21 pages

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Details

In December 1979, the Global Commission for the Certification of Smallpox Eradication declared the world free of smallpox and this declaration was ratified by the World Health Assembly in May 1980.

Since May 2022, cases of mpox have been reported in multiple countries that have not had endemic monkeypox virus (MPXV) in animal or human populations, including countries in Europe, North America and Australasia.

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