ATAGI interim statement on the use of vaccines for prevention of mpox in 2024

Overview of key points

• In response to an upsurge of mpox cases in Australia and the clade Ib outbreak in Africa, ATAGI has reviewed the evidence for vaccine use against current disease epidemiology to assess whether Australia’s mpox vaccination guidelines need updating. 
• Currently, ATAGI does not recommend booster doses of the mpox vaccine for people fully vaccinated (that is, 2 doses administered at least 28 days apart), including those who are severely immunocompromised. • Currently, ATAGI does not recommend vaccination for people travelling to areas where mpox cases are circulating, who do not meet the current vaccine eligibility. This includes travel to endemic Africa, where clade Ib is circulating. 
• The ATAGI recommendations for mpox vaccination have been updated to remove the age restriction; people of all ages who are at risk of exposure to mpox are recommended to receive the mpox vaccination. 
• ATAGI will monitor the evolving mpox epidemiology in Australia and other affected regions. Vaccine recommendations will continue to be reviewed and updated if required. 
• Published studies suggest that the JYNNEOS mpox vaccine is moderately to highly effective in reducing the severity of symptoms associated with mpox infection in fully vaccinated individuals.
• Two doses of an mpox vaccine appears to provide higher protection against mpox than a single dose.
• People recommended to receive the mpox vaccine and who received the first dose >28 days ago should receive their second dose as soon as possible to maximise protection. 
• ATAGI notes other global advisory groups are also not currently recommending booster doses for those who have completed a 2-dose schedule. 
• Ensuring more eligible people are fully vaccinated is essential to provide protection against severe disease/clinical manifestations associated with infection. Vaccination can also reduce the risk of onwards transmission to other at-risk individuals and communities.