What are the current guidelines for vaccination against Mpox in at-risk populations?

Current guidelines for vaccination against Mpox in at-risk populations focus on targeted immunisation strategies to prevent infection among those with increased exposure risk. Although the UK Green Book and NICE guidelines do not yet provide detailed, specific protocols for Mpox vaccination, the general principles of vaccine uptake in at-risk groups apply, including opportunistic identification and vaccination of eligible individuals during healthcare contacts, especially in sexual health services and community clinics where at-risk populations may present NICE NG218.

From the emerging literature on Mpox outbreaks, vaccination is recommended primarily for individuals at high risk, such as men who have sex with men (MSM), people with multiple sexual partners, healthcare workers exposed to Mpox patients, and close contacts of confirmed cases Bhat et al. 2023Musuka et al. 2024. The vaccine used is typically a modified vaccinia Ankara (MVA) vaccine, which is administered as a two-dose regimen to provide effective protection Bhat et al. 2023.

Implementation strategies emphasise the importance of culturally appropriate communication and tailored outreach to at-risk groups to improve vaccine uptake, consistent with NICE recommendations for vaccine delivery in vulnerable populations NICE NG218. This includes using reminders, education, and accessible vaccination points such as sexual health clinics and community health services Bhat et al. 2023Musuka et al. 2024.

Pre-exposure vaccination is advised for those at occupational risk, including healthcare workers and laboratory staff handling orthopoxviruses, aligning with the general approach to occupational vaccination in UK guidelines NICE NG218. Post-exposure prophylaxis vaccination is also recommended within 4 days of exposure to reduce disease severity Bhat et al. 2023.

In summary, current best practice integrates opportunistic vaccination of at-risk populations identified through healthcare contacts, targeted pre- and post-exposure vaccination for high-risk groups, and culturally sensitive communication strategies to enhance uptake. While UK guidelines provide a framework for vaccine delivery in at-risk groups broadly, recent literature on Mpox highlights specific populations and vaccine regimens to focus on for effective outbreak control Bhat et al. 2023Musuka et al. 2024 NICE NG218.