Multi-epitope vaccines: charting a new frontier in monkeypox prevention and control.

Monkeypox is a viral zoonotic infection that has emerged as a significant public health threat recently. The world has experienced a global outbreak of the Monkeypox virus (MPXV), with 124,753 confirmed cases in 128 countries and a total of 272 fatalities as of February 13, 2025. This alarming increase in cases demands immediate attention to the underlying causes of the surge. The World Health Organization (WHO) has endorsed the use of the MVA-BN vaccine, which was previously approved for smallpox prevention. However, there are currently no antiviral treatments approved by the FDA for MPXV. In addition, the emergence of mutations in MPXV strains poses challenges for the development and effectiveness of viable vaccines. Developing conventional vaccines is typically expensive, time-consuming, and requires extensive validation processes. Moreover, these vaccines often demonstrate suboptimal efficacy against emerging viral strains. As a response to these challenges, multi-epitope vaccines have gained significant interest for their potential to activate B-cell and T-cell responses, providing prolonged immunological activity against pathogens. These vaccines feature a targeted approach, offering chemical stability, non-infectious properties, rapid and cost-effective production, enhanced safety, and the potential to elicit a robust immune response. Several studies employing immunoinformatics have confirmed the efficacy of multi-epitope vaccines, designed to provide comprehensive immune protection against MPXV. These vaccines promise to deliver a strong immune response, better coverage against various viral strains and variants, and improved stability and effectiveness. In addition, they are expected to be non-allergenic, non-toxic, and highly antigenic. While promising results have been reported regarding the use of these vaccines for monkeypox, further research on their efficacy, delivery systems, and additional preclinical and clinical trials is crucial to maximize their benefits for humanity.