Mpox: Vaccine Guidance for Providers

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The Centers for Disease Control and Prevention (CDC) reports that there have been at least 14,000 identified cases of Monkeypox, now known as mpox, around the country and more worldwide. As a result, federal officials are taking steps to stop the outbreak. The U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) to allow healthcare providers to use the JYNNEOS Mpox vaccine by intradermal injection for individuals 18 years of age and older who are determined to be at high risk for Mpox infection as part of a nationwide effort to combat the outbreak. This will increase the total number of doses available for use.

Key Features of Mpox

Mpox lesions are often painful until the healing phase when they become itchy with scabs. It usually occurs in the genital and anorectal areas (with signs of pain or bleeding) or in the mouth. The rash is not always disseminated across multiple areas on the body and may be confirmed to one (1) or a few lesions.

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TRANSMISSION

Personal protective equipment (PPE) includes gloves, gown, NIOSH-approved particulate respiratory equipped with N95 filters or higher, and other face and eye protection (e.g., goggles, face shields) for potential splash or spray of bodily fluids. Any Environmental Protection Agency (EPA)-registered hospital-grade disinfectant or EPA’s List Q can be used for cleaning and disinfecting environmental surfaces.

A patient with suspected or confirmed mpox infection:

  • Should be placed in a single-person room; the door should be kept closed (if safe to do so),
  • The patient should have a dedicated bathroom; activities that could re-suspend dried material from lesions, e.g., use of portable fans, dry dusting, sweeping, or vacuuming, should be avoided;
  • Transport of the patient outside of the room should be limited to medically essential purposes.
  • If the patient is transported outside their room, they should use well-fitting source control (e.g., a medical mask) and have exposed skin lesions covered with a sheet or gown.

Soiled laundry (e.g., bedding, towels, personal clothing) should be gently and promptly contained in an appropriate laundry bag and never be shaken or handled in a manner that may disperse infectious particles. Wet cleaning methods are preferred. Activities such as dry dusting, sweeping, or vacuuming should be avoided. Waste (i.e., handling, storage, treatment, and disposal of soiled PPE, patient dressings, etc.) should be managed as medical waste.

Vaccines and Who Should Receive Them

Doctor giving patient a vaccine

There are two (2) currently licensed, FDA-approved vaccines in the United States to prevent smallpox, ACAM2000 and JYNNEOS. Since smallpox resembles the mpox virus, these vaccines have effectively protected people against mpox when given before exposure to the disease. However, currently, only JYNNEOS is being distributed to providers.

JYNNEOS is licensed for adults 18 years and over and those under 18 in special circumstances (dosing and administration vary depending on age).

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TESTING A PATIENT FOR MPOX AND REPORT FINDINGS

Testing a Patient for Mpox and Reporting Findings Commercial testing is available through several commercial labs.

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