Preemptive Mpox Vaccine Deployment: Aligning Strategy With Reality
By
Sung-mok Jung
Fuminari Miura
Hiroaki Murayama
Sebastian Funk
Jacco Wallinga
Justin Lessler
Akira Endo
July 21, 2025
Clinical Scorecard: Proactive Strategies for Mpox Vaccine Implementation: Bridging Theory and Practice
At a Glance
Category Detail
Condition Mpox (Monkeypox) infection, clade IIb and clade I Key Mechanisms Rapid infection spread in heterogeneous sexual networks; infection-acquired immunity in core groups; narrow time window for effective vaccination Target Population High-risk groups, particularly men who have sex with men with high numbers of sexual partners; broader populations in clade I outbreaks Care Setting Public health vaccination programs in outbreak and preemptive contexts
Key Highlights
Timing of vaccine deployment is critical due to rapid saturation of infection-acquired immunity in core groups. Reactive vaccination often occurs after sustained transmission, limiting population-level impact despite individual protection. Preemptive vaccination strategies face challenges including early detection, political dilemmas, and logistical constraints. Guideline-Based Recommendations
Diagnosis
Enhance timely case detection to identify early transmission signals. Address structural barriers such as social stigma and limited diagnostic capacity. Management
Implement intensive vaccination targeting high-risk populations promptly. Tailor vaccination timing and targets to local epidemiologic and social contexts, considering clade-specific transmission patterns. Monitoring & Follow-up
Use real-time importation risk modeling to inform early-warning and vaccination decisions. Maintain surveillance systems for timely outbreak information sharing. Risks
Delayed vaccine deployment reduces population-level impact and herd immunity potential. Political and operational challenges may delay preemptive vaccination. Risk of overreaction when initiating vaccination without confirmed local transmission. Patient & Prescribing Data
High-risk individuals during clade IIb outbreaks; broader populations in clade I outbreaks
Vaccines demonstrate 66%–85% effectiveness against disease; delayed administration limits indirect protection benefits.
Clinical Best Practices
Prioritize early and proactive vaccination in high-risk groups to interrupt transmission. Invest in resilient infrastructure and public trust to support vaccination efforts. Coordinate globally to ensure equitable vaccine access and timely outbreak information sharing. Adapt immunization strategies to local transmission dynamics and clade differences. References
