Appraising the current landscape of reviews on mpox vaccination: a rapid evidence map

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Abstract Introduction Vaccination is a potent countermeasure for interrupting the spread of mpox, which is currently a priority public health problem in Africa. Backed by emergency declarations from both the World Health Organization (WHO) and the Africa Centres for Disease Control and Prevention (CDC), governments, with support from health partners, are accelerating momentum for mpox vaccine deployment in countries with active transmission to prevent further spread. Although evidence is crucial for informing mpox vaccination policies and practice decisions, the existing knowledge gaps are not well explored. Objective To identify existing reviews on mpox vaccination and assess the evidence landscape to identify knowledge gaps. Methods A rapid review approach was used to map the existing synthesized literature on mpox vaccination. Results The database search (finalized in September 2024) included seven electronic databases and yielded 1650 results. After systematic screening based on predefined inclusion criteria, 31 reviews were selected. These included 17 systematic reviews, 11 narrative reviews, and three rapid reviews on mpox vaccination. Most of the literature focused on the immunogenicity, safety, efficacy, and effectiveness of first- and second-generation mpox vaccines. However, there is limited evidence on the immunogenicity, safety, efficacy, and effectiveness of third-generation vaccines (including the WHO-prequalified Modified Vaccinia Ankara–Bavarian Nordic vaccine) in Africa and among subpopulations such as children, women of reproductive age, and pregnant women. Additionally, existing studies on vaccine acceptance and uptake mainly concentrate on men who have sex with men, with insufficient evidence concerning other high-risk groups like female sex workers. Conclusion This study has identified gaps both in the scarcity of studies on the immunogenicity, safety, efficacy, and effectiveness of MVA-BN in African settings, as well as in the target populations of the outbreak. There is an urgent need to accelerate mpox vaccination research in Africa through primary studies and evidence synthesis.

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