Smallpox vaccination campaigns resulted in age-associated population cross-immunity against monkeypox virus.

We observed a clear trend in the relative levels of antibodies with year of birth, with higher levels of antibodies detected in older patients.

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We observed no significant difference between the youngest group and any other group for MPXV-M1R and borderline significant differences in levels of anti-VACV-L1R in the 1971–2001 group compared to the 1961–1965 group ( P value 0.0471, Wilcoxon test, Fig. 1 ).

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