CROI 2023: Get people at-risk for mpox vaccinated now to avoid spring resurgence, experts say

During the height of the global mpox outbreak in 2022, men who have sex with men took remarkable steps to protect themselves and their partners, and it made a difference, according to researchers at the Conference on Retroviruses and Opportunistic Infections in Seattle earlier this week. More than 48% of MSM in the U.S. reduced their number of sexual partners, 50% reduced their number of one-time sexual encounters, and 49% reduced sex with partners they met on dating apps or at sex venues.

In the absence of clear guidance and communication at the height of the outbreak, an audience member at a special session on mpox said, members of the LGBTQ community “felt abandoned and stranded” by public health authorities. “We had to take care of ourselves and share information amongst ourselves.”

This substantial reduction in risk-taking behavior had an impact, but vaccination remains the key for preventing new outbreaks in the future, said John Brooks, MD, of the Centers for Disease Control and Prevention. Individuals who received two doses of the Jynneos vaccine were 10 times less likely to become infected with mpox, Dr. Brooks said.

“To avert future resurgences, we really need to get people vaccinated, especially those who are immunosuppressed or compromised,” Dr. Brooks said, as people with HIV are at higher risk of developing serious and prolonged illness and the painful lesions associated with mpox infection.

However, during the peak of the outbreak, the Jynneos vaccine to prevent mpox infection was difficult to access, the audience member said, especially for Black and Latino men.

“You promoted vaccine uptake, but the U.S. didn’t get enough doses,” he said, sharing that he himself was only able to get a dose when he attended the International AIDS Conference in Montreal in July 2022 and that others he knew drove to Canada to get vaccinated.

Dr. Brooks said the vaccine was made available but acknowledged that CDC and other public health authorities need to improve accessibility to populations that are harder to reach. Another audience member commented that much of the imagery in vaccination campaigns featured young, White gay men, “but that doesn’t line up with the populations that need to be reached.”

“Predominantly, people who were better off were reaching out for the vaccine but not other populations,” the audience member added.

Dr. Brooks said that in addition to communicating to at-risk populations that “now is the time to protect yourself” and that vaccination campaigns need to proactively reach out to more marginalized groups to ensure they have access.