Serum nAb titers of first-generation vaccine recipients with or without a booster dose of Imvamune/Imvanex. (A) Serum VACV nAb titers of laboratory workers vaccinated by first-generation vaccine with (orange bars) and without (white bars) a booster dose, illustrated by the reciprocal serum dilution. (B) Comparison of VACV nAb titers between individuals with and without a booster dose. (C) Serum MPXV nAb levels of laboratory workers with or without a booster dose. (D) Comparison of MPXV nAb titers of first-generation vaccine recipients and those who received a booster dose. Serum nAbs titers of individuals listed in panels (A) and (C) are in the same order, for comparison of VACV and MPXV nAb titers. Statistical significance was evaluated through Mann-Whitney t-test (ns, non-significant p = 0.1014, 0.2343, respectively) The dashed lines: limit of detection, 1:10 dilution. Reciprocal serum dilution: virus neutralization >50 % compared to control.