On September 23, 2022, the Public Health Agency of Canada (PHAC) released updated guidance from the National Advisory Committee on Immunization (NACI) on the use of the Imvamune® vaccine in the context of ongoing monkeypox outbreaks in Canada.

This updated guidance is based on current evidence and NACI's expert opinion and builds on NACI’s interim guidance on the use of Imvamune® in the context of monkeypox outbreaks in Canada published on June 10, 2022.

This updated guidance includes recommendations on the use of Imvamune® for preexposure vaccination and dose-sparing strategies that may be considered to maximize vaccine coverage when supply is limited.

In developing these recommendations, NACI considered the epidemiology of ongoing Canadian and international monkeypox outbreaks, the growing evidence on the safety and protection offered by the Imvamune® vaccine against monkeypox, the current and projected supply of Imvamune® in Canada and feedback from stakeholder groups representing individuals considered most at risk for infection.

In the context of an active monkeypox outbreak, NACI recommends that the Imvamune® vaccine should be offered as pre-exposure vaccination to individuals with highest risk of monkeypox*. Pre-exposure vaccination is when Imvamune® is administered before known exposure to the virus. After considering the current and projected outbreak epidemiology, NACI recommends the following individuals be considered for pre-exposure vaccination (Strong NACI Recommendation):

  • Men who have sex with men (MSM)**, and individuals who have sex with MSM, and who meet at least one of the following criteria:
  1. Having two or more sexual partners or who are in a relationship where at least one of the partners has other sexual partners
  2. Having had a confirmed sexually transmitted infection in the past year
  3. Engaging in sexual contact in sex-on-premises venues o Individuals who self-identify as sex workers, regardless of self-identified sex/ gender
  • Staff or volunteers in sex-on-premises venues where workers may have contact with objects or materials that may be contaminated with the monkeypox virus without the use of personal protective equipment
  • Recommendation
  • Americas
  • Canada
  • outbreak
  • Mpox // Monkeypox