Can people with eczema have an mpox vaccine?

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Currently, there are two mpox vaccines available in the United States:

• ACAM2000 vaccine
• Jynneos vaccine

People with eczema have an impaired skin barrier, which a virus may take advantage of and cause a more severe and widespread infection than in people without skin barrier issues.

The ACAM2000 vaccine can replicate and may cause eczema vaccinatum, which is a severe condition that can be life threatening.

According to the Centers for Disease Control and Prevention (CDC), the ACAM2000 vaccine is not safe for people with:

• eczema or atopic dermatitis
• a history of eczema, atopic dermatitis, or any acute or exfoliative skin conditions

The ACAM2000 vaccine is also unsafe for people with:

• severe immunodeficiency, such as those undergoing bone marrow transplantation or those with HIV or AIDS
• underlying heart disease, such as cardiomyopathy and coronary artery disease

The ACAM2000 vaccine also has more known side effects than the Jynneos vaccine.

People with eczema will also need to avoid contact with anyone who has had an mpox vaccine, particularly the ACAM2000 vaccine, for around 30 days. Exposure to people who have had a recent mpox vaccine may put people with eczema at risk of developing eczema vaccinatum.

Jynneos is suitable for people with eczema. The Jynneos vaccine uses a replication-deficient virus, which means the virus does not replicate, and so it does not have the same risks as the ACAM2000 vaccine.

Learn about mpox here.

People will need to take extra care if they have previously had an allergic reaction to any vaccine. People may still be able to receive the Jynneos vaccine, but a healthcare professional will need to monitor them for 30 minutes afterward.

The Jyennos vaccine is preservative-free and uses a non-latex vial stopper. People will also need to let a healthcare professional know if they are allergic to:

• gentamicin or ciprofloxacin antibiotics
• chicken or egg protein

People would need to avoid any further doses of the Jynneos vaccine if they had a severe allergic reaction after getting the first Jynneos dose.

According to the CDC, Jynneos in people with atopic dermatitis may have a protective immune effect against mpox with no known adverse effects. Despite vaccination, people with atopic dermatitis may still have an increased risk of severe infection from workplace exposure.

According to the CDC, the Jynneos vaccine effectively lowers the risk of mpox infection. Two doses of the vaccine may provide the highest level of protection.

Estimates suggest one dose may be 37% effective against mpox, and two doses may be 69% effective against mpox. These percentages may vary for different genders and types of vaccine administration.

The CDC recommends the Jynneos vaccine if people:

• have known or suspected exposure to a person with mpox
• have had sexual contact in the last 2 weeks with a person with mpox
• are men who have sex with men, or any transgender, nonbinary, or gender-diverse person who has had a new diagnosis of a sexually transmitted infection or more than one sexual partner in the previous 6 months
• have had sex at a commercial sex venue in the previous 6 months
• have had sex at a large commercial event or geographical area where mpox transmission is present in the previous 6 months
• have had sex with anyone with the above risk factors, or if people anticipate experiencing any of those risk factors
• have immune suppression, such as HIV, and have experienced or anticipate experiencing the above risk factors
• may have possible exposure to mpox from the workplace, such as people who work with orthopoxviruses in a laboratory setting or as a response team

If a person with eczema develops mpox, or suspects they have come into contact with the virus that causes it, they must contact a healthcare professional immediately.

It is also essential that anyone with mpox takes steps to prevent passing the virus on. Mpox can pass on through direct contact with the affected areas of the skin and fluid from the blisters.

People will need to follow preventive measures until the rash has fully healed and a new layer of skin has formed. People without symptoms cannot transmit the virus to other people.

The American Academy of Dermatology Association provides the following advice for people with mpox:

• wash the skin with mild soap and water
• avoid sharing towels, bath linen, or clothing with other people
• cover lesions by wearing long pants and sleeves until the scabs have fallen off and new skin forms
• use sun protection of at least SPF 30 for at least 3 months to prevent scarring
• consider keeping fingernails short to avoid scratching lesions, which may lead to secondary infection
• contact a healthcare professional immediately if lesions become infected
• use silicone-based gels or sheeting if scarring is a concern
• take baths to help soothe the skin
• try warm or cold compresses, or a sitz bath, to soothe skin in the anogenital area

Tecovirimat is an antiviral medication for people with mpox who are at severe risk, including those with eczema. Tecovirimat reduces the amount of mpox virus in the body.

Tecovirimat is a Food and Drug Administration (FDA) approved drug to treat smallpox but is not currently FDA approved for mpox. This means it is currently an investigational drug, and people must sign a consent form to acknowledge this before taking it.

Tecovirimat may help lessen severe mpox and reduce pain, swelling, and scarring.

Other treatment options that are also new but less common than Tecovirimat include:

• antivirals, such as brincidofovir and cidofovir
• vaccinia immune globulin intravenous (VIGIV)

Over-the-counter pain relief medications, such as ibuprofen and acetaminophen, may also help relieve painful symptoms.

Steps to prevent mpox include:

• avoiding close contact with people who have mpox symptoms
• avoiding sharing personal items with a person who has mpox
• getting vaccinated if at high risk of exposure
• frequent handwashing
• avoiding contact with animals that may spread mpox

Read handwashing advice for people with skin conditions here.

People with eczema have an increased risk of severe infection from mpox and the ACAM2000 vaccine. People with eczema can receive the Jynneos mpox vaccine.

People with eczema should avoid anyone with mpox symptoms or who recently had an mpox vaccine. People will need to contact a doctor if they have any symptoms of mpox.