Information for Health Departments

Health departments play an enormous role in helping slow the spread of mpox. To be most effective, mpox vaccination should be included as part of broader prevention activities and routine sexual health care. For example:

• Offering mpox vaccine alongside other vaccines like COVID-19 or flu vaccine
• Including mpox prevention in discussions about HIV PEP, HIV PReP, or doxy PEP with patients and clients
• Allowing individuals to self-attest their vaccine eligibility (i.e., providing mpox vaccination without requiring individuals to specify which criterion they meet)
• Discussing behavioral strategies to minimize risk when vaccine is not an option for the patient

Include mpox education and offer the vaccine during public health events and activities including:

• Community health fairs
• On site vaccination events where groups of people disproportionately impacted by mpox may get together
• Mobile testing vans
• Street outreach

Mpox vaccination strategies are likely to be most effective when designed and implemented in partnership with communities and groups that are disproportionately affected.

During the ongoing 2022 global mpox outbreak, most U.S. cases have been among gay, bisexual, and other men who have sex with men (MSM) and their sexual partners. Following the peak of the outbreak in August 2022 with more than 3,000 cases per week, cases declined sharply but remain consistent at about 59 reported cases per week.

The Advisory Committee on Immunization Practices recommends persons at risk of exposure receive two doses of the JYNNEOS vaccine. At this time, only one in four of the approximately two million people eligible to receive the vaccine in the United States have received both doses.

Vaccination remains an important, but underutilized, tool in stopping the spread of mpox. The size of a potential mpox outbreak varies with a county’s population immunity from vaccination coverage and previous mpox case rates. In counties with immunity greater than 50 percent, outbreaks are expected to be smaller. In communities with immunity less than 50 percent, more people being vaccinated against mpox can reduce the risk of an outbreak.

Mpox and Health Equity

CDC is committed to health equity, which means everyone has fair and just opportunity to attain their highest level of health. For mpox, this includes reliable access to safe and effective mpox vaccines and timely, clear, and accurate information.

Mpox case rates have been disproportionately higher among Black and Hispanic or Latino MSM and, in smaller numbers, Black and Hispanic or Latina women. Gender minorities, including transgender women and non-binary people, have also been disproportionately affected by mpox. Since October 2023, cases continue to occur primarily among cisgender men and those who identified as gay or bisexual. Of these, people self-identified:

• 34 percent Hispanic or Latino
• 32 percent White
• 25 percent Black
• 3 percent Asian
• 2 percent multiracial
• 4 percent another race, including American Indian or Alaska Native and Native Hawaiian or Pacific Islander

At the same time, the most recent vaccine administration data show those who are disproportionately affected by mpox have lower vaccination rates. Of all people who received both recommended JYNNEOS doses and reported race and ethnicity:

• 5 percent identify as Hispanic or Latino
• 7 percent identify as White
• 6 percent identify as Black
• 3 percent identify as Asian
• 1 percent identify as multiracial
• .2 percent identify as another race, including American Indian or Alaska Native and Native Hawaiian or Pacific Islander

Many social, geographic, political, economic, and environmental factors create challenges to health equity and vaccination access. Some of these factors include:

• Literacy, education, income, and wealth gaps
• Language differences
• Job access and working conditions
• Racism, homophobia, transphobia, and other forms of misinformation and discrimination
• Gaps in healthcare access
• Transportation and neighborhood conditions
• Lack of trust because of past medical racism and experimentation
• Perceived or actual stigma when accessing medical care
• Lack of access to online scheduling technology
• Low vaccine confidence

In addition to mpox vaccination events, health departments should include mpox prevention messaging throughout the year when working with communities disproportionately affected by mpox, including gay, bisexual, and other MSM; gender minorities; and Black and Hispanic or Latina women.

Resources

• National Coalition of Sexual Health Directors mpox promotional materials toolkit
• National Coalition of STD Directors: Mpox Communications Toolkit and Creative Assets
• Mpox Vaccine Recommendations
• Safer Sex, Social Gatherings, and Mpox
• Monkeypox Virus Infections After 2 Preexposure Doses of JYNNEOS Vaccine — United States, May 2022–May 2024
• Notes from the Field: Clade II Mpox Surveillance Update — United States, October 2023–April 2024
• The CDC Domestic Mpox Response — United States, 2022–2023