Nearly a week after confirming it has detected 13 cases of mpox in 2024, Singapore has approved Bavarian Nordic’s Jynneos vaccine for adults.

Those deemed at high risk of mpox or smallpox infection will be eligible to take the shot, which was previously available in Singapore under emergency use provisions, as per a 27 August press release.

Singapore’s regulatory update is part of a wider shift by many other countries who are making the move to fully approve the vaccine amid the ongoing outbreak in Africa.

Earlier this month, Singapore’s health minister Ong Ye Kung stated the risk of an mpox outbreak in the country was low but added that cases would likely arrive due to Singapore being a hub for flight connections. Singapore’s airport is one of the world’s busiest airports and has the most passengers passing through its terminals in Asia. Singapore had a population of 5.92 million as of June 2023.

All 13 detected cases of mpox in the city-state have occurred from the clade 2 variant, as per a bulletin released last week. The current outbreak in Africa is caused by the more serious clade Ib variant.

Thailand, a near neighbour to Singapore, confirmed its first clade Ib case on Thursday last week. Singapore’s health ministry said it would start screening for mpox symptoms at airport and sea border checkpoints.  

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Bavarian Nordic’s Jynneos is the only US Food and Drug Administration (FDA)-approved vaccine for mpox. It is also approved in Europe, known under the brand name Imvanex.

Following the World Health Organization’s (WHO) declaration of a public health emergency of international concern, Africa Centres for Disease Control and Prevention (CDC) has called for a timely delivery of vaccines. WHO will now decide whether to issue an emergency use listing for an mpox vaccine, which would allow Africa’s vaccine procurers to buy vaccines.

In a statement announcing the approval in Singapore, Bavarian Nordic’s CEO Paul Chaplin said the company is continuing to work with regulators in other countries to further broaden its access.

Chaplin added: “Importantly, we are currently supporting the WHO Emergency Use Listing process and the Africa CDC to ensure rapid availability of the vaccine in the African continent, where prophylactic solutions are urgently needed.”

Jynneos generated sales of $730m in 2023, nearly thrice as much as in 2022, with vaccine revenue now expected to skyrocket in the remainder of 2024. Bavarian Nordic has already designated 215,000 doses of the vaccine for countries affected by mpox outbreaks in Africa. Emergent, the only other large-scale manufacturer of a smallpox vaccine, said it would donate 50,000 doses of its vaccine to countries in the region. Emergent’s ACAM2000 vaccine is approved for smallpox, but it is currently available for mpox immunisation under the Expanded Access Investigational New Drug (EA-IND) protocol.