Eurosurveillance - Volume 31, Issue 30, 30 July 2026

In May 2022, first cases of mpox clade IIb were detected in Germany, and MVA-BN vaccine was available from June 2022 onwards. Vaccination has been recommended by the Standing Committee on Vaccination (STIKO) since June 2022 to contain monkeypox virus infection and prevent disease.

Our primary aim was to evaluate the safety of the mpox vaccine Jynneos (modified Vaccinia Ankara, Bavaria-Nordic, MVA-BN) after the rollout of the vaccination campaign in Germany from June 2022 to February 2024; a secondary aim was to describe mpox cases and vaccinations.

To identify cases and persons with adverse events following immunisation (AEFIs), we used existing surveillance systems. A voluntary system was implemented in June 2022 to monitor mpox vaccination. We performed a descriptive analysis of cases, vaccinations, individual case safety reports (ICSRs) and AEFIs.

Until 29 February 2024, 3,807 mpox cases were notified (data retrieved July 2024). According to the voluntary mpox vaccination monitoring, a total of 78,739 mpox vaccine doses of Jynneos were administered. A search of the national AEFI database identified 32 ICSRs, of which seven were serious. A total of 87 AEFIs were reported, most of which were local or systemic reactions that are generally associated with vaccination. The overall adverse event reporting rate adjusted for missing information on vaccine utilisation in one of 16 federal states was 98.7 adverse events per 100,000 doses.

The safety profile of the MVA-BN vaccine was in line with the summary of product characteristics. No new safety signals were identified.

Seasonal respiratory pathogens place recurrent pressure on health services, creating a need for timely detection of seasonal onset and assessment of within-season intensity.

We aimed to evaluate the Automated and Early Detection of Seasonal Epidemic Onset and Burden Levels (AEDSEO) method, developed using Danish respiratory surveillance data, externally.

Using 63 surveillance series of influenza, respiratory syncytial virus (RSV), acute respiratory infection (ARI) and influenza-like illness (ILI) from 21 European countries, season onset detection was compared with the Moving Epidemic Method (MEM), while intensity level categorisation was compared with MEM, the World Health Organization Average Curve Method (WHO-ACM) and the Mean Standard Deviation method (MSD).

The AEDSEO method signalled onset in 60 of 63 surveillance series, while MEM crossed its epidemic threshold in 55 of 63. Among 55 surveillance series in which both methods signalled onset, AEDSEO signalled earlier in 45. Median lead times were 6.5 weeks for influenza, 4.5 for RSV, 22.0 for ARI and 5.5 for ILI. Growth after the AEDSEO onset signal was usually sustained, particularly for influenza, RSV and ILI. The AEDSEO method provided more consistent within-season intensity categorisation across seasons than MEM, WHO-ACM and MSD.

Across diverse European respiratory surveillance series AEDSEO supported earlier detection of seasonal onset than MEM and more consistent within-season intensity categorisation than MEM, WHO-ACM and MSD. Its current operational use in the Danish national respiratory surveillance system further supports its practical applicability for timely situational assessment, planning, and communication of respiratory pathogen activity.