Monkeypox outbreak triggers conspiracy theories on social media claiming that it was planned or incorrectly linking it to COVID-19 vaccines

On 13 May 2022, the U.K. Health Security Agency (UKHSA) notified the World Health Organization (WHO) of two confirmed cases of monkeypox in patients from the same household and without recent travel history to areas where the virus circulates. Monkeypox is a rare disease caused by the monkeypox virus, which belongs to the Orthopoxvirus genus. This genus also includes the variola virus that caused the now-eradicated smallpox. Monkeypox causes symptoms similar to smallpox but typically milder.

The monkeypox virus is endemic in tropical rainforest areas of Central and West Africa, mainly in the Democratic Republic of the Congo. This means that the virus generally circulates only in these geographic areas. In contrast, transmission in non-endemic countries is very rare. While occasional cases of monkeypox have occurred outside of Africa, they are generally linked to international travel or imported animals.

On 15 May 2022, the WHO issued a multi-country alert about an increase in cases of monkeypox in non-endemic areas. As of 21 May 2022, the organization has recorded 92 laboratory-confirmed cases and 28 suspected cases of monkeypox in nine European countries and in the U.S., Canada, and Australia.

These unusual cases of monkeypox triggered conspiratorial claims on social media, with some going particularly viral, like a YouTube video by musician An0maly. Some claimed that the outbreak was planned, as happened with COVID-19 early in the pandemic. Other claims suggested that the monkeypox cases were caused by the adenoviral vector used in some COVID-19 vaccines, or that the outbreak is a hoax.

Below, we analyze each of these claims and explain why they are incorrect, misleading, and unsubstantiated by scientific evidence.

Monkeypox is a zoonotic disease, transmitted from animals to humans; there is no evidence of any link with COVID-19 vaccines

Following the monkeypox outbreak, multiple theories about its origin spread on social media. One Facebook post claimed that the virus “was created in a lab and given via injection”. The post based the claim on the fact that monkeypox was first identified in 1958 in colonies of macaques kept in a facility in Copenhagen, Denmark. However, this claim is incorrect.

Monkeypox is a zoonotic disease, which means that it is caused by a naturally occurring virus that jumped from animals to humans. Many animal species, including rodents and non-human primates, are susceptible to infection with the monkeypox virus. According to later studies, the monkeypox virus isolated from the macaques in Denmark likely originated in West Africa and naturally infected the macaques. There are also no signs of engineering in the virus that caused the recent cases of monkeypox; the WHO reported that all cases confirmed to date involve known variants from West Africa.

Other posts suggested that the Oxford-AstraZeneca COVID-19 vaccine might be behind the monkeypox cases because it contains a chimpanzee adenovirus vector (examples here, here, here, and here). During an episode of his show, conspiracy theorist Alex Jones made similar claims that the Oxford-AstraZeneca and the Johnson and Johnson COVID-19 vaccines are “virus vectors that inject the genome of a chimpanzee into your cells”. These claims are incorrect and unsubstantiated by scientific evidence.

To begin with, the claim that the Johnson and Johnson vaccine uses a chimpanzee adenoviral vector is inaccurate. Both the Oxford-AstraZeneca and the Johnson and Johnson COVID-19 vaccines use adenoviral vectors, which are harmless modified versions of an adenovirus that carry the genetic instructions for producing the SARS-CoV-2 spike protein in the cells. However, the adenoviral vector in the Johnson and Johnson vaccine is based on the human adenovirus type 26 that causes mild cold symptoms and pink eye in humans^[1].

The Oxford-AstraZeneca COVID-19 vaccine does use a chimpanzee adenoviral vector (ChAdOx1)^[2]. However, adenoviruses are a family of viruses different from the pox viruses to which the monkeypox belongs, and don’t cause pox-like illnesses but respiratory infections. The adenovirus used in the Oxford-AstraZeneca vaccine is responsible for causing the common cold in chimpanzees. The adenoviral vector is also not produced in monkeys but in human cells grown in a Petri dish.

Furthermore, the virus vectors used in these vaccines cannot cause disease, because they are modified to be replication-deficient. That means that the vectors used in the Oxford-AstraZeneca and the Johnson and Johnson COVID-19 vaccines cannot multiply and infect humans.

In other words, none of the COVID-19 vaccines contain the monkeypox virus, no part of their production process involves monkeys, and the adenoviral vectors they use can’t multiply to cause an infection. Therefore, there is no plausible mechanism by which COVID-19 vaccines could trigger a monkeypox outbreak.

Pandemic simulations help improve response to future outbreaks; the fact that an outbreak with similar characteristics eventually occurs isn’t evidence that it was planned

In March 2021, the Nuclear Threat Initiative (NTI) and the Munich Security Conference jointly held a pandemic simulation exercise. The exercise scenario portrayed a “deadly, global pandemic involving an unusual strain of monkeypox virus” engineered in a laboratory and released in the fictional country of Brinia on 15 May 2022 due to a terrorist attack. At the end of the exercise, the virus caused “more than three billion cases and 270 million fatalities worldwide”.

The similarity between this scenario and the first real cases of monkeypox notified in the U.K. on 13 May 2022 triggered conspiracy theories about the outbreak being planned or the monkeypox virus deliberately released. One example is a video published by a musician who goes by the alias An0maly and has more than one and a half million followers on Facebook and over 250,000 subscribers to his YouTube channel.

An0maly, who spread misinformation about COVID-19 vaccines in the past, suggested a link between the monkeypox simulation and previous conspiracy theories about world depopulation. Specifically, he compared the monkeypox exercise with a 2019 simulation of a coronavirus pandemic and claimed, “they came together, they planned their response of [sic] a coronavirus pandemic, and then six months later they really rolled out the plan”. In a reference to Bill Gates and co-founder of the NTI Ted Turner, An0maly said, “they don’t want to hurt you, it’s just they think there’s too many people on the planet and they want less people over time”.

Another video was published by someone who goes by the alias Amazing Polly. An article in The Conversation described this person as a “QAnon influencer” who was allegedly responsible for spreading the conspiracy theory that the furniture retail company Wayfair was selling children on its website. Amazing Polly stated that the similarities between the pandemic exercise and the real monkeypox outbreak are “a bit too coincidental”. She added that “this monkeypox thing is just a reiteration of what they have done in the past with anthrax, with coronavirus, and now with monkeypox” and it is “meant to terrorize people into getting vaccines” for the economic profit of some.

Both videos linked the 2021 simulation exercise to debunked conspiracy theory claiming that Event 201, another exercise simulating a pandemic caused by a coronavirus and held in New York in October 2019, was evidence that the COVID-19 pandemic was planned. However, available evidence doesn’t support any of these claims.

On 24 May 2022, the NTI issued a statement explaining that “[t]he fact that several countries are currently experiencing an outbreak of monkeypox is purely a coincidence”. The organization stated that “[t]he risks posed by monkeypox have been well documented for years”^[3]. For example, the U.S. Centers for Disease Control and Prevention (CDC) lists monkeypox on the U.S. Select Agents and Toxins List that includes biological agents and toxins with potential to pose a severe threat to both human and animal health.

In fact, pandemic preparedness exercises are common in many countries. An0maly presented with suspicion the fact that “the world’s most powerful people come to these simulations and really kind of plan everything that they would do if a pandemic came, like a coronavirus or monkeypox”. However, that is precisely the objective of these simulations: to raise awareness about potential biological threats and help to improve responses in case a real pandemic occurs.

Likewise, the objective of the NTI simulation exercise was to identify “gaps in national and international biosecurity and pandemic preparedness”. In fact, the NTI and the Munich Security Conference organize similar outbreak simulations annually involving threats such as a pneumonic plague (2019), an influenza virus (2020), and the Akhmeta virus (2022), a cowpox virus identified in 2012 that belongs to the same genus as the monkeypox virus.

The NTI further pointed out that the exercise scenario involved a massive release of an engineered monkeypox virus that was very lethal and vaccine-resistant. In contrast, monkeypox is less likely to cause a pandemic in the current circumstances, where there is a low number of cases caused by a known natural virus that causes mild disease and for which vaccines are effective.

The NTI also clarified that “[w]e have no reason to believe that the current outbreak involves an engineered pathogen, as we have not seen any compelling evidence that would support such a hypothesis.” As we explained above, the WHO stated that all cases whose samples were confirmed by PCR involved the  known West African strain of the monkeypox virus. In fact, the genome sequences were very similar to cases of monkeypox exported from Nigeria to the U.K., Israel, and Singapore in 2018 and 2019, evidence that indicates the virus is naturally-occurring.

In short, these pandemic preparedness exercises aren’t evidence of an orchestrated disease outbreak. Instead, they aim to improve global response to pandemics. The coincidental choice of the monkeypox virus for the pandemic exercise is justified by its potential to cause outbreaks.

The rapid availability of smallpox vaccines is due to the continuous production for emergency stockpiling

Amazing Polly and others (examples here and here) insinuated that the monkeypox outbreak was released or planned to profit economically by selling vaccines against it. Most of them mentioned Jynneos, a smallpox vaccine that also prevents monkeypox and that the U.S. Food and Drug Administration approved for adults “at high risk for smallpox or monkeypox infection” in September 2019.

While some posts incorrectly claimed that the vaccine is from Pfizer, it is the Dutch biotechnology company Bavarian Nordic that produces the vaccine. The company recently announced that the U.S. had ordered 13 million doses of Jynneos, which some saw as evidence that monkeypox was planned in order to sell the vaccine. However, this claim is incorrect and unsupported.

In a news release, Bavarian Nordic explained that the order was part of a contract with the U.S. government that started in 2003 with the objective of increasing the national stockpile of smallpox vaccines.The U.S. and the WHO have been stockpiling emergency smallpox vaccines for years. Although vaccination stopped following smallpox eradication, public health authorities recognized the necessity of keeping an emergency reserve that would allow them to respond quickly in the case of a natural re-emergence of smallpox or a biological attack.

But the original smallpox vaccine was a live vaccine with many contraindications. That is why the U.S. FDA approved Jynneos, a replication-deficient vaccine that can also be used in people with immunodeficiencies or other conditions who couldn’t receive the original vaccine. However, the WHO states that there is currently no need for mass vaccination against monkeypox, and the vaccine should be limited to those at high risk of infection.

The reuse or misuse of photos of rashes attributed to monkeypox isn’t evidence that the current outbreak is a hoax

Some Facebook posts shared multiple screenshots of news articles that illustrated the current monkeypox outbreak with reused photos of skin rashes or stock photos that appeared earlier on other websites. This fact-check by PolitiFact extensively researched the origin of each of these photos. The posts suggested that, because the images were used before, current monkeypox cases aren’t real. However, this implication is incorrect.

While the use of a generic image might potentially mislead the readers about the circumstances of the event, it doesn’t make the actual event less real. This would be like saying that a basketball match never took place simply because someone used a stock image in a news report about that match.

Purchasing stock images or reusing file photos to illustrate articles is common practice in media outlets and none of the articles, which were published in The Independent, NBC News, BBC News, and the Daily Mail, stated that the photos were current. That said, in an article published by the Poynter Institute for Media Studies, KMIZ News director Curtis Varns explained that using generic images without correctly attributing their source can be “very misleading” and have a “long-term impact on credibility”. The best practice is to clearly disclose that the image is an “illustration”, he said.

This Facebook post is a good example of how generic images can harm credibility, particularly when misused. The post juxtaposed two screenshots of articles showing the same photo of a hand with a rash. One of the screenshots illustrated shingles rash on the website of the department of health of Queensland, Australia. The other one was from an article on the website The Health Site, which incorrectly used the same shingles photo in a story about a case of monkeypox identified in the U.S. in May 2021.

Although both monkeypox and shingles cause similar symptoms, including rash, they are different diseases caused by different viruses. Shingles are caused by the varicella zoster virus, which is also responsible for chickenpox. Thus, the incorrect use of the shingles photo to illustrate the rash caused by monkeypox was misused one year later to cast suspicion on the monkeypox outbreak.

Conclusion

Vaccine ingredients, pandemic tabletop exercises, and reused pictures don’t provide evidence that the monkeypox outbreak doesn’t exist, was planned, or results from laboratory experiments or COVID-19 vaccination. Those claims are unsubstantiated by any scientific evidence and remain in the realm of conspiracy theories.

UPDATE (1 June 2022):

This review was updated to add a statement by the NTI explaining that the monkeypox virus shows no signs of engineering and to provide further context regarding the strains of the virus involved in the monkeypox outbreak.

REFERENCES

• 1 – Sadoff et al. (2021) Safety and Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19. New England Journal of Medicine.
• 2 – Dicks et al. (2012) A Novel Chimpanzee Adenovirus Vector with Low Human Seroprevalence: Improved Systems for Vector Derivation and Comparative Immunogenicity. PLoS ONE.
• 3 – Bunge et al. (2022) The changing epidemiology of human monkeypox—A potential threat? A systematic review. PLoS Neglected Tropical Diseases.