Last updated: 18 February 2026

Terms of Reference

In 2013, the WHO Strategic Advisory Group of Experts (SAGE) on Immunization issued recommendations on the use of smallpox vaccines. Given new epidemiological and vaccine-related developments, a Working Group has been established to revise the relevant data on the use of vaccines against smallpox, mpox and other orthopoxviruses. Specifically, the Working Group is tasked to review the evidence with respect to use of smallpox and mpox vaccines in three specific areas of public health concern, namely global health security, occupational health and safety, and prevention and control of mpox and other orthopoxvirus infections. Based on this review of evidence, SAGE will be asked to propose updated recommendations. 

Composition

SAGE Members

•  Rebecca Grais, Executive Director, Pasteur Network, France (Chair of the Working Group)
• Anthony Scott, KEMRI-Wellcome Trust Research Programme in Kilifi, Kenya

Experts

• Clarissa Damaso, Federal University of Rio de Janeiro, Brazil.
• Poh Lian Lim, National Centre for Infectious Diseases, Singapore.
• Kristine Macartney,  National Centre for Immunisation Research and Surveillance (NCIRS), Australia.
• Raina MacIntyre, University of New South Wales, Australia.
• Adesola Yinka Ogunleye, Chatham House African Public Health Leaders Fellow, UK
• Gregory Poland, Mayo Clinic College of Medicine, USA
• Agam Rao, National Institutes of Health, USA (until January 2026).
• Anne Rimoin, University of California, USA.
• Patrick Katoto, Tropical Diseases and Global Health University of Bukavu, Democratic Republic of the Congo.
• Lorna Leal, European Medicines Agency (EMA), Netherlands.
• Omar Sultan, Tanzania.

WHO secretariat

• Rosamund Lewis
• Judith van Holten

Declarations of Interest

All members completed a declaration of interests form. 6 Working Group members reported relevant interests. All interests were assessed not to constitute a conflict of interest. It was concluded that all members could take part in full in all of the proceedings of the Working Group.

All the reported relevant interests are summarized below:

    Clarissa Damaso:

• Her institution receives research grants from the Brazilian public funding agencies, the Bill and Melinda Gates Foundation and Tonix Pharmaceuticals to study the genotypic diversity and phylogenetic relationships of the historical Brazilian smallpox vaccine with other historical smallpox vaccines from the late XIX and early XX centuries. These interests were perceived as non-personal, specific and financially insignificant.

  Poh Lian Lim:

• Serves on the expert committee on COVID-19 vaccination and appointed by the Ministry of Health, Singapore. This interest was perceived as non-personal, non-specific and financially insignificant.
• Serves on the expert committee on immunizations and appointed by the Ministry of Health, Singapore. This interest was perceived as non-personal, non-specific and financially insignificant.
• Serves on the independent allocation of vaccines group (IAVG) as chair. This interest was perceived as non-personal, non-specific and financially insignificant.

  Raina Macintyre:

• Her institution receives research grants from Sanofi to study the burden of influenza in adults. This interest was perceived as non-personal, non-specific and financially significant
• Her institution receives funds from Moderna for her role as principal investigator in the CMV Victory trial. This interest was perceived as non-personal, non-specific and financially significant*.
• Her institution received research grants from Seqirus for a project on the burden of influenza in adults. This interest was perceived as non-personal, non-specific and financially significant*.
• Her institution received funds from Emergent Biosolutions, Bavarian Nordic, Siga Technologies and Meridien Medical Technologies for the Pacific Eclipse biothreat simulation. These interests were perceived as non-personal, specific and financially significant*.
• Her institution received funds from Orebro Hospital for her role as principal investigator in the influenza and myocardial infarction trial. This interest was perceived as non-personal, non-specific and financially significant*.
• Serves on the Flucelvax advisory board of Seqirus. This interests were perceived as non-personal, non-specific and financially insignificant.
• Served on the pneumococcal vaccine advisory board and FluAD of Seqirus. These interests were perceived as non-personal, non-specific and financially insignificant.
• Served on the pneumococcal vaccine advisory board of Pfizer. This interest was perceived as non-personal, non-specific and financially insignificant.
• Served on the Fluzone High dose advisory board of Sanofi. This interest was perceived as non-personal, non-specific and financially insignificant.
• Served on the smallpox and monkeypox roundtable of Bavarian Nordic. This interest was perceived as non-personal, specific and financially insignificant.
• Serves as a member of the NHMRC National COVID-19 Health and Research Advisory Committee meeting 2020 and as a member of COVID Antibody Working group (National COVID-19 Health and Research Advisory Committee meeting 2020) from the Australian government. This interest was perceived as personal, non-specific and financially insignificant.
• Serves as a member of the NSW Health COVID-19 vaccine advisory group 2020 from the NSW government. This interests was perceived as non-personal, non-specific and financially insignificant.

    Gregory Poland

• Receives funds as a member of the scientific advisory board from Atria, GSK, Merck, Moderna and Valneva. These interests were perceived as personal, non-specific and financially significant*.
• Receives funds for consulting and advisory work from 3D Communications, AstraZeneca, Eli Lily, Emergent Biosolutions, Exelixis, Inc, Genevant, Janssen Global Services, Ocugen, Regeneron, Syneos and Vyriad. These interests were perceived as personal, specific and financially significant*.
• Receives benefits from commercial entity from Terrapin, Elsevier and the National Foundation for Infectious Diseases. These interests was perceived as personal, non-specific and financially significant*.

  Agam Rao

• Served as lead for the USA Centers for Disease Control (CDC)’s Orthopoxvirus ACIP workgroup. 
  This interest was perceived as non-personal, specific and financially insignificant.
  
  

* According to WHO's Guidelines for Declaration of Interests (WHO expert), an interest is considered "personal" if it generates financial or non-financial gain to the expert, such as consulting income or a patent. "Specificity" states whether the declared interest is a subject matter of the meeting or work to be undertaken. An interest has "financial significance" if the honoraria, consultancy fee or other received funding, including those received by expert's organization, from any single vaccine manufacturer or other vaccine-related company exceeds 5,000 USD in a calendar year. Likewise, a shareholding in any one vaccine manufacturer or other vaccine-related company in excess of 1,000 USD would also constitute a “significant shareholding”. As per WHO assessment of conflicts of interests, “Institution” relates only to the expert’s research/or work unit, as subdivision of the department. Funding going to the SAGE Working Group member’s research unit needs to be declared.