Using smallpox vaccine for monkeypox exposure

Jo Jenkins, Specialist Pharmacist (Patient Group Directions), Medicines Use and Safety (SPS)Published Last updated See all updates

Considerations for giving smallpox vaccine pre or post exposure during a monkeypox incident.

Currently available stock

The current stock in the UK is Imvanex® suspension for injection, containing smallpox vaccine (Live Modified Vaccinia Virus Ankara).

Licence status

Imvanex® is unlicensed in the UK, but is licensed in the EU so pharmaceutical quality is assured. Product information, including the SmPC and PIL in English, can be found on the European Medicines Agency website.

Packs of current UK stock of Imvanex® are labelled in three languages: English, French and German.

A prescription is the only legal mechanism that can be used to supply and administer an unlicensed medicine. This prescription is sometimes referred to as a Patient Specific Direction (PSD)

For more information on using PSDs see Questions about Patient Specific Directions (PSD)

Handling of Imvanex®

Information about the handling of Imvanex® smallpox vaccine can be found on the European Medicines Agency website.

Clinical information

The UK Health Security Agency has issued guidance on the use of pre and post exposure vaccination during a monkeypox incident, along with a chapter in the Green Book.


This page reflects the current situation on the day of publication and any subsequent changes will be incorporated.

Change history

  1. Link to Green Book chapter added
  1. Labelling language confirmed.
  1. Updated to reflect current understanding of labelling language.
  2. Published