{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:03:07Z","timestamp":1785499387629,"version":"3.56.0"},"reference-count":26,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"unspecified","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010414","name":"Health Research Board","doi-asserted-by":"crossref","award":["MONKEYVAX-2022-1"],"award-info":[{"award-number":["MONKEYVAX-2022-1"]}],"id":[{"id":"10.13039\/100010414","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Global Health EDCTP3","award":["101195540-MpoxVax AFRIVAC"],"award-info":[{"award-number":["101195540-MpoxVax AFRIVAC"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,16]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Mpox remains an ongoing global health concern, driven by an ongoing clade I outbreak in Central Africa, which has caused substantial morbidity and mortality. Despite deployment of the Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN) vaccine, data on the durability of vaccine-induced immune responses remain limited, particularly in African populations, women and people with HIV, highlighting the need for context-specific immunogenicity data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>Mpox-Vax AFRIVAC is a prospective, multicentre observational cohort study conducted in Uganda, Tanzania and the Democratic Republic of the Congo (DRC). Adults eligible for MVA-BN vaccination for mpox prevention or who received a first dose within 28 days prior to enrolment are followed for 48 weeks. Serial blood samples are collected to quantify binding antibody responses and assess their durability over time. The primary outcomes are mean geometric MVA-BN-specific antibody titres at week 48 and the rate of antibody decay from week 6 to week 48. Secondary outcomes include antibody kinetics at intermediate time points, factors associated with immune responses, breakthrough infection and vaccine safety. Analyses will use descriptive and longitudinal statistical methods to evaluate immune response trajectories and associated host factors, including HIV status, age and sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study is conducted in accordance with the Declaration of Helsinki, registered at the Pan African Clinical Trials Registry (PACTR202601855406764) and publications will be in accordance with the recommendations of the International Committee of Medical Journal Editors. The study has received ethical approvals in Uganda, DRC and Tanzania. Approval for Uganda has been obtained from Uganda Virus Research Institute Research and Ethics Committee (GC\/127\/1062) and Uganda National Council for Science and Technology (HS5575ES), for DRC from the Institutional Committee of Health ethics (UCB\/CIES\/PB\/001\/2025) and for Tanzania from the National Institute for Medical Research (NIMR\/HQ\/R.8a\/Vol.IX\/5187).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>PACTR202601855406764.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-120064","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:40:22Z","timestamp":1785498022000},"page":"e120064","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Examining the immune response of participants receiving Modified Vaccinia Ankara vaccine in Africa (MpoxVax AFRIVAC): a prospective cohort study \u2013 protocol"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0184-0947","authenticated-orcid":false,"given":"Joanne","family":"Byrne","sequence":"first","affiliation":[{"name":"Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Dublin, Ireland"},{"name":"Department of Infectious Diseases, St Vincent\u2019s University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7154-2964","authenticated-orcid":false,"given":"Winters","family":"Muttamba","sequence":"additional","affiliation":[{"name":"Interdisciplinary Consortium for Epidemics Research (ICER), Kampala, Uganda"},{"name":"Makerere University Lung Institute, Kampala, Central Region, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Balola Ntaboba","sequence":"additional","affiliation":[{"name":"Center for Tropical Diseases and Global Health, Faculty of Medicine, Catholic University of Bukavu, Bukavu, South-Kivu, Congo (the Democratic Republic of the)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bariki","family":"Mtafya","sequence":"additional","affiliation":[{"name":"National Institute for Medical Research (NIMR)-Mbeya Medical Research Center, Mbeya, Tanzania, United Republic of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8635-2925","authenticated-orcid":false,"given":"Mudarshiru","family":"Bbuye","sequence":"additional","affiliation":[{"name":"Interdisciplinary Consortium for Epidemics Research (ICER), Kampala, Uganda"},{"name":"Makerere University Lung Institute, Kampala, Central Region, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Kalyebi Watelo","sequence":"additional","affiliation":[{"name":"Medical Research Council\/Uganda Virus Research Institute and London School of Hygiene, Tropical Medicine Uganda Research Unit, Entebbe, Uganda"},{"name":"Uganda National Health Research Organization, Berkeley Lane, Entebbe, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Alvarez Barco","sequence":"additional","affiliation":[{"name":"Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayleen","family":"Mufudza","sequence":"additional","affiliation":[{"name":"Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barnabas","family":"Bakamutumaho","sequence":"additional","affiliation":[{"name":"Interdisciplinary Consortium for Epidemics Research (ICER), Kampala, Uganda"},{"name":"Medical Research Council\/Uganda Virus Research Institute and London School of Hygiene, Tropical Medicine Uganda 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Elias","family":"Ntinginya","sequence":"additional","affiliation":[{"name":"National Institute for Medical Research (NIMR)-Mbeya Medical Research Center, Mbeya, Tanzania, United Republic of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick D M C","family":"Katoto","sequence":"additional","affiliation":[{"name":"Center for Tropical Diseases and Global Health, Faculty of Medicine, Catholic University of Bukavu, Bukavu, South-Kivu, Congo (the Democratic Republic of the)"},{"name":"Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, Western Cape, South Africa"},{"name":"Cochrane South Africa, South African Medical Research Council, Cape Town, Western Cape, South 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