Vaccination Strategies

As of October 2022, most (99%) cases were among men, and 94% reported male-to-male sexual or close intimate contact during the 3 weeks before symptom onset. A substantial proportion of cases (57%) occurred among people living with HIV infection. Health disparities by race and ethnicity have been reported, with a disproportionate number of cases among people who are Black and Hispanic. 

Mpox can spread to anyone through close, personal, often skin-to-skin contact. 

People can be vaccinated after exposure to mpox to help prevent illness.

Under the national vaccine strategy, available JYNNEOS vaccine is being distributed to jurisdictions to use for post-exposure prophylaxis (PEP) and for vaccination prior to exposure.

Vaccination after known or presumed exposure to mpox virus (PEP) may be offered to:

• People who are known contacts to someone with mpox identified by public health authorities, for example via case investigation, contact tracing, or risk exposure assessment
• People who are aware that a recent sex partner within the past 14 days was diagnosed with mpox
• Gay, bisexual, or other men who have sex with men, or transgender or nonbinary people (including adolescents who fall into any of the aforementioned categories), who have had any of the following within the past 14 days: sex with multiple partners (or group sex); sex at a commercial sex venue; or sex in association with an event, venue, or defined geographic area where mpox transmission is occurring

Vaccine prior to exposure to mpox virus should be offered and encouraged to people who have the highest potential for exposure to mpox virus such as:

• Gay, bisexual, and other men who have sex with men, transgender or nonbinary people who in the past 6 months have had
• A new diagnosis of one or more nationally reportable sexually transmitted diseases (e.g., chlamydia, gonorrhea, syphilis); or
  
• More than one sex partner
  
• People who have had any of the following in the past 6 months:
  
• Sex at a commercial sex venue; or
  
• Sex in association with a large public event in a geographic area where mpox transmission is occurring
  
• Sexual partners of people with the above risks
  
• People with HIV infection or other causes of immunosuppression who have had recent or anticipate potential mpox exposure
  

Longstanding recommendations are unchanged to use vaccines prior to exposure specifically for people with certain occupational exposures. In alignment with existing guidance from the Advisory Committee on Immunization Practices, these recommendations for vaccination prior to exposure apply specifically to research laboratory personnel working with orthopoxviruses, clinical laboratory personnel performing diagnostic testing for orthopoxviruses, and health care worker response teams designated by appropriate public health authorities.

To be most effective, strategies to use mpox vaccines prior to exposure should be part of a larger prevention effort accounting for impacted communities, local epidemiology, population needs, and feasibility based on available vaccine supply. Such an effort should center health equity principles as a foundation and include strategies such as community outreach, education efforts, and communication about behavioral strategies to minimize risk. Strategies to use vaccines prior to exposure are likely to be most effective when designed and implemented in partnership with communities and groups that are disproportionately affected. For example, successful HIV PrEP campaigns were built on a high level of community engagement and have built a high amount of trust. As the epidemiology of the outbreak evolves and new data become available, interim guidance on mpox vaccine use prior to exposure will be updated.

For more information on vaccination strategy, see: CDC| Components of the U.S. National Monkeypox Vaccination Strategy