Effectiveness of one dose of MVA-BN vaccine against mpox infection in males in Ontario, Canada: A target trial emulation
Bibliographic record
Abstract
ABSTRACT Background Limited evidence is available on the real-world effectiveness of modified vaccinia Ankara-Bavarian Nordic vaccine (MVA-BN) against mpox infection. Methods We emulated a target trial using linked databases in Ontario, Canada to estimate the effectiveness of one dose of MVA-BN. Our study included males aged ≥18 years who: (1) had a history of syphilis testing and a laboratory-confirmed bacterial sexually transmitted infection (STI) in the prior year; or (2) filled a prescription for HIV pre-exposure prophylaxis in the prior year. On each day between June 12, 2022 and October 27, 2022, males who had been vaccinated 15 days prior were matched 1:1 with unvaccinated males by age, geographic region, prior HIV diagnosis, number of bacterial STI diagnoses in the previous three years, and receipt of any non- MVA-BN vaccine in the previous year. We used a Cox proportional hazards model to estimate the hazard ratio comparing the incidence of mpox between the two groups, and calculated vaccine effectiveness as (1–HR)x100. Results Each group included 3,204 males. A total of 71 mpox infections were diagnosed over the study period, with 0.09 (95% confidence interval [CI], 0.05–0.13) per 1000 person-days for the vaccinated group and 0.20 (95%CI, 0.15–0.27) per 1000 person-days for the unvaccinated group. Estimated vaccine effectiveness of one dose of MVA-BN against mpox infection was 59% (95%CI, 31–76%). Conclusions This study, conducted in the context of a targeted vaccination program and evolving outbreak, suggests that one dose of MVA-BN is moderately effective in preventing mpox infection.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".