Skip to main content

Drug Interactions between sars-cov-2(covid-19)mrna(tozinameran 5y-11y)bivalent vaccine and smallpox and monkeypox vaccine

This report displays the potential drug interactions for the following 2 drugs:

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

smallpox and monkeypox vaccine SARS-CoV-2(COVID-19)mRNA(tozinameran 5y-11y)bivalent vaccine

Applies to: smallpox and monkeypox vaccine and sars-cov-2(covid-19)mrna(tozinameran 5y-11y)bivalent vaccine

ADJUST DOSING INTERVAL: Coadministration of an orthopoxvirus vaccine with mRNA or Novavax SARS-CoV-2 (COVID-19) vaccines may increase the risk of myocarditis and pericarditis. The replication-competent smallpox vaccine as well as the mRNA and Novavax COVID-19 vaccines have all been associated with cases of myocarditis and pericarditis; however, the risk in the live, attenuated, non-replicating smallpox and monkeypox vaccine is hypothetical. Current data do not suggest an increased risk for myocarditis after receipt of the smallpox and monkeypox vaccine, but the possibility of a small risk cannot be excluded. Myocarditis associated with the smallpox vaccine is thought to be due to an immune-mediated phenomenon, and it is not known whether the antigen(s) that precipitate autoantibodies are also present in the smallpox and monkeypox vaccine.

MANAGEMENT: A 4-week interval should be considered between administration of an orthopoxvirus vaccine and an mRNA or Novavax COVID-19 vaccine due to the observed risk for myocarditis and pericarditis after receipt of those types of COVID-19 vaccines and the replication-competent smallpox vaccine, as well as the hypothetical risk associated with the non-replicating smallpox and monkeypox vaccine. This may be particularly important for those at greater risk of this adverse event, such as adolescent or young adult males. Some authorities recommend prioritizing the receipt of the smallpox and monkeypox vaccine over the replication-competent smallpox vaccine when co-administering a COVID-19 vaccine and an orthopoxvirus vaccine. If a patient's risk of smallpox, monkeypox, or severe disease due to COVID-19 is increased (e.g., during an outbreak), administration of these vaccines should not be delayed. Current immunization guidelines should be consulted.

References

  1. US Food and Drug Administration (2020) Emergency Use Authorization. Emergency Use Authorization (EUA) information, and list of all current EUAs. https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization
  2. CDC Centers for Disease Control and Prevention (2022) Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html
  3. Rao AK, Petersen BW, Whitehill F, et al. (2022) "Use of JYNNEOS (Smallpox and Monkeypox Vaccine, Live, Nonreplicating) for Preexposure Vaccination of Persons at Risk for Occupational Exposure to Orthopoxviruses: Recommendations of the Advisory Committee on Immunization Practices--United States, 2022 ht"
  4. (2018) "Product Information. ACAM2000 (smallpox vaccine)." Emergent BioSolutions Inc.
  5. Anonymous. (2022) Updated ATAGI Clinical Guidance on Vaccination Against MPX (Monkeypox) https://www.health.gov.au/sites/default/files/documents/2022/08/atagi-clinical-guidance-on-vaccination-against-monkeypox.pdf
  6. Centers for Disease Control and Prevention (2023) Use of COVID-19 vaccines in the U.S. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html
  7. Australian Government. Department of Health and Aged Care (2023) Australian immunisation handbook: COVID-19. https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/covid-19
  8. Centers for Disease Control and Prevention (CDC) (2023) Safety monitoring of JYNNEOS vaccine during the 2022 mpox outbreak - united states, May 22-October 21, 2022. https://www.cdc.gov/mmwr/volumes/71/wr/mm7149a4.htm
View all 8 references

Switch to consumer interaction data

Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

Report options

Loading...
QR code containing a link to this page

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer