Current state of monkeypox vaccine development

Abstract

The global monkeypox outbreak in 2022, which affected more than 120 countries, marked the transition of this disease from an endemic condition to a global public-health threat. A decline in herd immunity following cessation of routine smallpox vaccination, together with the insufficiency of existing vaccines, underscores the necessity for development of new immunoprophylactic measures against monkeypox. The aim of this review is to summarize the evidence on contemporary candidate vaccines against monkeypox developed using different approaches. To prepare this review, a literature search was conducted in PubMed, Scopus, Elsevier, Google Scholar, and RSCI up to August 2025. The following keywords were used: MPXV, Monkeypox, vaccine, monkeypox virus. The review addresses both classical live attenuated vaccinia virus-based vaccines, previously approved for prevention of monkeypox, and vaccines being developed using recombinant technologies, including DNA and mRNA vaccines. Their immunological characteristics, safety profiles, and potential for further clinical application are presented.