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IMVANEX Injectable Suspension

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About the medicine

How to use IMVANEX Injectable Suspension

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the User

IMVANEX injectable suspension

Vaccine against smallpox and monkeypox (modified Ankara vaccinia virus)

This medicine is subject to additional monitoring, which will allow for the quick identification of new safety information. You can help by reporting any side effects you may get. The last section of section 4 will tell you how to report side effects.

Read all of this leaflet carefully before you receive this vaccine because it contains important information for you.

  • Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or nurse.
  • If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack

  1. What is IMVANEX and what is it used for
  2. What you need to know before you are given IMVANEX
  3. How IMVANEX is given
  4. Possible side effects
  5. Storing IMVANEX
  6. Contents of the pack and other information

1. What is IMVANEX and what is it used for

IMVANEX is a vaccine used to prevent smallpox, monkeypox, and disease caused by cowpox virus in adults and adolescents from 12 years of age.

When the vaccine is given to a person, the immune system (the body's natural defense system) produces its own protection in the form of antibodies against the smallpox virus, monkeypox virus, and cowpox viruses.

IMVANEX does not contain the smallpox virus (Variola) or the monkeypox virus or the cowpox viruses. It cannot cause or spread infection and disease caused by the smallpox virus, monkeypox virus, or cowpox viruses.

Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

2. What you need to know before you are given IMVANEX

You should not receive IMVANEX:

  • if you are allergic or have previously suffered a sudden and potentially life-threatening allergic reaction to the active substance or any of the other ingredients of this medicine (listed in section 6) or to chicken proteins, benzonase, gentamicin, or ciprofloxacin, which may be present in the vaccine in very small amounts.

Warnings and precautions

Talk to your doctor or nurse before receiving IMVANEX:

  • if you have atopic dermatitis (see section 4).
  • if you have an HIV infection or any other disease or treatment that weakens the immune system.
  • if you are nervous about receiving the vaccine or have ever fainted after an injection with a needle.

The efficacy of IMVANEX in protecting against smallpox, monkeypox, and disease caused by cowpox virus has not been studied in humans.

In case of illness with high fever, your doctor will postpone vaccination until you are better. The presence of a minor infection, such as a cold, should not require postponement of vaccination, but consult your doctor or nurse first.

It is possible that IMVANEX may not fully protect all people who receive the vaccine.

Previous vaccination with IMVANEX may alter the skin response ("take") to subsequent smallpox vaccines with replicating viruses and cause reduced or absent take of these vaccines.

Other medicines or vaccines and IMVANEX

Tell your doctor or nurse if you are taking or have recently taken any other medicine or if you have recently received any other vaccine.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor. The use of this vaccine is not recommended during pregnancy and breastfeeding. However, your doctor will assess whether the potential benefit of preventing smallpox, monkeypox, and disease caused by cowpox virus outweighs the potential risks to you and your baby.

Driving and using machines

No information is available on the effects of IMVANEX on the ability to drive or use machines. However, if you experience any of the side effects included in section 4, some of them may affect your ability to drive or use machines (e.g., dizziness).

IMVANEX contains sodium

This medicine contains less than 1 mmol of sodium (23 mg) per dose, which is essentially "sodium-free".

3. How IMVANEX is given

You can receive this vaccine whether or not you have been vaccinated against smallpox in the past.

Your doctor or nurse will inject the vaccine under your skin, preferably in the upper arm. It should not be injected into a blood vessel.

If you have never been vaccinated against smallpox, monkeypox, or cowpox viruses:

  • You will receive two injections.
  • The second injection will be given no less than 28 days after the first.
  • Make sure to complete the two-injection vaccination course.

If you have been previously vaccinated against smallpox, monkeypox, or cowpox viruses:

  • You will receive one injection.
  • If your immune system is weakened, you will receive two injections, and the second will be given no less than 28 days after the first.

If you miss an appointment for an IMVANEX injection

If you miss a scheduled injection, talk to your doctor or nurse and schedule another appointment.

If you have any other questions about the use of this vaccine, ask your doctor or nurse.

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

4. Possible side effects

Like all medicines, this vaccine can cause side effects, although not everybody gets them.

Serious side effects

Get in touch with a doctor or go immediately to the Emergency Department of the nearest hospital if you experience any of the following symptoms:

  • difficulty breathing
  • dizziness
  • swelling of the face and neck

These symptoms may be indicative of a severe allergic reaction.

Other side effects

If you already have atopic dermatitis, you may experience more intense local skin reactions (such as redness, swelling, and itching) and other general symptoms (such as headache, muscle pain, nausea, or fatigue), as well as an exacerbation or worsening of your skin problem.

The most frequently reported side effects occurred at the injection site. Most were mild to moderate and resolved without treatment within a period of seven days.

Tell your doctor if you experience any of the following side effects:

Very common(may affect more than 1 in 10 people):

  • headache
  • muscle pain
  • nausea
  • fatigue
  • pain, redness, swelling, induration, or itching at the injection site

Common(may affect up to 1 in 10 people):

  • chills
  • fever
  • joint pain, limb pain
  • loss of appetite
  • lump, discoloration, bruising, or warmth at the injection site

Uncommon(may affect up to 1 in 100 people):

  • nose and throat infection, upper respiratory tract infection
  • swelling of the lymph nodes
  • sleep disorders
  • dizziness, abnormal skin sensations
  • muscle stiffness
  • sore throat, nasal discharge, cough
  • diarrhea, vomiting
  • rash, itching, skin inflammation
  • bleeding, irritation
  • swelling under the arm, feeling unwell, flushing, chest pain
  • increased cardiac laboratory values (such as troponin I), increased liver enzymes, decreased white blood cell count, decreased platelet volume

Rare(may affect up to 1 in 1,000 people):

  • sinus infection
  • flu
  • redness and discomfort in the eye
  • hives (urticaria)
  • skin discoloration
  • sweating
  • skin bruising
  • night sweats
  • skin lump
  • back pain
  • neck pain
  • muscle cramps
  • muscle pain
  • muscle weakness
  • swelling of the ankles, feet, or toes
  • rapid heartbeat
  • ear and throat pain
  • abdominal pain
  • dry mouth
  • feeling of spinning (vertigo)
  • migraine
  • nervous disorder that causes weakness, numbness, or tingling
  • drowsiness
  • flaking, inflammation, abnormal sensation in the skin, reaction at the injection site, rash, numbness, dryness, reduced mobility, blisters at the injection site
  • weakness
  • pseudoinfluenza syndrome
  • swelling of the face, mouth, and throat
  • increased white blood cell count
  • bruising

Frequency not known(cannot be estimated from the available data):

  • temporary facial paralysis (Bell's palsy) on one side

Reporting of side effects

If you experience any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly through the national reporting system listed in Appendix V. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storing IMVANEX

Keep this medicine out of the sight and reach of children.

Do not use this vaccine after the expiry date which is stated on the label after EXP. The expiry date is the last day of the month shown.

Store in a freezer (at -20°C ± 5°C or -50°C ± 10°C or -80°C ± 10°C). The expiry date depends on the storage temperature. Do not re-freeze the vaccine once thawed. After thawing, the vaccine can be stored between 2°C and 8°C in the dark for a maximum of 2 months, within the approved validity period, before use.

Store in the original package to protect from light.

6. Contents of the pack and other information

What is in IMVANEX

One dose (0.5 ml) contains:

  • The active substance is the modified Ankara vaccinia virus - Bavarian Nordic1, at least 5 x 10^7 IU.*
  • infectious units

1 Produced in chicken embryo cells.

  • The other ingredients are: trometamol, sodium chloride, and water for injections.

This vaccine contains residual traces of chicken proteins, benzonase, gentamicin, and ciprofloxacin.

Appearance and packaging

After thawing, IMVANEX is a milky white to pale yellow injectable suspension.

IMVANEX is supplied as an injectable suspension in a vial (0.5 ml).

IMVANEX is available in packs of 1 vial or 20 vials.

Not all pack sizes may be marketed.

Marketing authorisation holder and manufacturer

Marketing authorisation holder

Bavarian Nordic A/S

Philip Heymans Allé 3

DK-2900 Hellerup

Denmark

Phone +45 3326 8383

Email [email protected]

Manufacturer

Bavarian Nordic A/S

Hejreskovvej 10A,

3490 Kvistgaard

Denmark

Date of last revision of this leaflet:

This medicine has been authorised under exceptional circumstances. This means that due to the rarity of this disease, it has not been possible to obtain complete information on this medicine.

The European Medicines Agency will review any new information that may become available every year and this leaflet will be updated as necessary.

More detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu.

The leaflet is also available in all languages of the European Union/European Economic Area on the European Medicines Agency web site.

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This information is intended for healthcare professionals only:

Instructions for preparation and administration of the vaccine:

The vial should be allowed to reach a temperature between 8°C and 25°C before use. Shake gently before use. Visually inspect the suspension before administration. If particles or an abnormal appearance are observed, the vaccine should be discarded.

Each vial is for single use.

Draw up a dose of 0.5 ml into a syringe for injection.

After thawing, the vaccine can be stored between 2°C and 8°C in the dark for a maximum of 2 months, within the approved validity period, before use.

Do not re-freeze the vaccine once thawed.

In the absence of compatibility studies, this vaccine must not be mixed with other vaccines.

Online doctors for IMVANEX Injectable Suspension

Discuss questions about IMVANEX Injectable Suspension, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

5.0 (4)
Doctor

Tomasz Grzelewski

Dermatology 21 years exp.

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques. For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance. Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults. In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions. Patients commonly seek his care for: 

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns

Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.

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€80
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Doctor

Andreea Mateescu

Paediatrics 8 years exp.

Dr Andreea Mateescu is a board-certified paediatrician with 7 years of clinical experience. She graduated from Carol Davila University of Medicine and Pharmacy in Bucharest, Romania, and completed her paediatric residency at INSMC Alessandrescu-Rusescu. She also holds additional training in general ultrasound diagnostics.

Dr Mateescu focuses on providing high-quality, evidence-based medical care for children, with a strong emphasis on prevention, healthy development, and long-term wellbeing. She believes that clear, empathetic communication with both children and parents is essential for building trust and ensuring effective care.

Online consultations with Dr Mateescu are suitable for:

  • preventive check-ups and monitoring of growth and development;
  • vaccination planning, including personalised and catch-up schedules;
  • assessment of psychomotor, emotional, and physical development;
  • diagnosis and management of acute and chronic paediatric conditions;
  • nutritional guidance for infants and children, including formula selection when medically indicated;
  • care for children with complex or rare conditions;
  • practical guidance and ongoing support for parents.
Dr Mateescu works with patience, empathy, and professionalism, ensuring that each child receives attentive, individualised care. Her goal is to support healthy, balanced development while helping parents feel confident and well-informed at every stage of their child’s care.
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€60
0.0 (0)
Doctor

Chikeluo Okeke

General medicine 4 years exp.

Dr Chikeluo Okeke is an internal medicine doctor with extensive international clinical experience. Originally from Nigeria, he has worked across multiple European healthcare systems and currently practises in Sweden. This professional path has given him a strong understanding of different medical approaches and the ability to work effectively with patients from diverse cultural and linguistic backgrounds.

Dr Okeke focuses on general internal medicine and adult primary care, combining clinical accuracy with careful attention to lifestyle, personal context, and everyday health concerns. His consultations are particularly well suited for people who seek medical advice online, live abroad, or need clear guidance without unnecessary complexity.

He provides online consultations covering symptom assessment, prevention, and long-term management of chronic conditions, helping patients understand what is happening and decide on appropriate next steps.

Common reasons for consultation:

  • General internal medicine concerns and initial health assessment.
  • Acute symptoms such as fever, cough, infections, pain, or weakness.
  • Chronic conditions and treatment adjustment.
  • Blood pressure issues, fatigue, metabolic concerns.
  • Preventive consultations and routine check-ups.
  • Interpretation of laboratory results and medical reports.
  • Medical advice for patients receiving care online.

Dr Okeke is known for his clear communication, calm approach, and cultural awareness. He listens carefully, explains medical decisions in a structured way, and supports patients in making informed choices about their health.

Online consultations with Dr Chikeluo Okeke offer reliable internal medicine care without geographic limitations, focused on medical relevance, clarity, and patient comfort.

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€60
5.0 (25)
Doctor

Lina Travkina

Family medicine 13 years exp.

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

Areas of medical care include:

  • Respiratory conditions: colds, flu, acute and chronic bronchitis, mild to moderate pneumonia, bronchial asthma.
  • ENT and eye conditions: sinusitis, tonsillitis, pharyngitis, otitis, infectious and allergic conjunctivitis.
  • Digestive issues: gastritis, acid reflux (GERD), IBS, dyspepsia, bloating, constipation, diarrhoea, functional bowel symptoms, intestinal infections.
  • Urological and infectious diseases: acute and recurrent cystitis, bladder and kidney infections, prevention of recurrent UTIs, asymptomatic bacteriuria.
  • Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
  • Neurological and general symptoms: headache, migraine, dizziness, fatigue, sleep disturbances, reduced concentration, anxiety, asthenia.
  • Chronic pain support: back, neck, joint, and muscle pain, tension syndromes, pain associated with osteochondrosis and chronic conditions.

Additional care areas:

  • Preventive consultations and check-up planning.
  • Medical advice and follow-up consultations.
  • Test interpretation and diagnostic guidance.
  • Structured support for undiagnosed complaints.
  • Second opinion on diagnoses and treatment plans.
  • Nutritional and lifestyle support for vitamin deficiencies, anaemia, metabolic issues.
  • Post-operative recovery support and pain management.
  • Preconception counselling and postpartum support.
  • Immunity support and strategies to reduce frequency of infections.

Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

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€70
5.0 (808)
Doctor

Alina Tsurkan

Family medicine 13 years exp.

Dr. Alina Tsurkan is a licensed family medicine physician based in Portugal, offering online consultations for adults and children. She provides professional primary care, with a focus on prevention, accurate diagnosis, and long-term management of acute and chronic conditions.

Dr. Tsurkan supports patients with a wide range of health issues, including:

  • Respiratory infections: cold, flu, bronchitis, pneumonia, and lingering coughs.
  • ENT conditions: sinusitis, tonsillitis, otitis (ear infections), sore throat, allergic rhinitis.
  • Eye conditions: allergic or infectious conjunctivitis, red eyes, irritation.
  • Digestive issues: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), constipation, bloating, nausea.
  • Urinary and reproductive health: urinary tract infections (UTIs), cystitis, prevention of recurrent infections.
  • Chronic diseases: hypertension, elevated cholesterol, weight management.
  • Neurological complaints: headaches, migraines, sleep disturbances, fatigue, general weakness.
  • Children’s health: fever, infections, digestive issues, follow-ups, vaccination guidance.

She also provides:

  • IMT medical certificates for driving licence exchange in Portugal.
  • Personalised preventive care and wellness consultations.
  • Interpretation of test results and medical reports.
  • Follow-up care and medication review.
  • Support in managing multiple coexisting conditions.
  • Remote prescription management and medical documentation.

Dr. Tsurkan’s approach is evidence-based and holistic. She works closely with each patient to develop an individualised care plan that addresses both symptoms and root causes. Her goal is to empower patients to take control of their health and maintain well-being through lifestyle adjustments, routine check-ups, and early intervention.

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€55
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Frequently Asked Questions

Is a prescription required for IMVANEX Injectable Suspension?
IMVANEX Injectable Suspension requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
Who manufactures IMVANEX Injectable Suspension?
IMVANEX Injectable Suspension is manufactured by Bavarian Nordic A/S. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of IMVANEX Injectable Suspension online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether IMVANEX Injectable Suspension is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to IMVANEX Injectable Suspension?
Other medicines with the same active substance () include ABRYSVO powder and solvent for injectable solution, AREXVY powder and suspension for injectable suspension, MRESVIA DISPERSION INJECTABLE IN PRE-FILLED SYRINGE. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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