SMART (Smallpox vaccine for Mpox Post-Exposure Prophylaxis: A Cluster Randomized Controlled Trial)

It is important to determine how effective smallpox vaccine is in preventing illness in household members exposed to someone with mpox when given after exposure. There are no studies that have compared people vaccinated after such exposure with those who were not vaccinated. The best design to study this is a randomized trial. The Smallpox vaccine for Mpox post-exposure prophylaxis: A cluster Randomized controlled Trial (SMART) is a pragmatic, randomized trial where households will be randomized to either one dose of the Imvamune® smallpox vaccine or to typhoid vaccine which will serve as a control. The objective is to see if the smallpox vaccines reduce confirmed mpox and symptom severity. The study will be conducted in Nigeria. Preparation for this trial has been ongoing for the past six months. The Canadian and Nigerian teams include infectious disease experts, dermatologists, immunologists, public health physicians, biologists, virologists. This research will generate key information about prevention of mpox. It will allow for clinical trial implementation in Africa with immunological testing in Canada, and in so doing will strengthen capacity in Canada to undertake interdisciplinary research on viral zoonotic infections of domestic or global origins.