Vaccination strategies to achieve outbreak control for MPXV Clade I with a one-time mass campaign in sub-Saharan Africa: A scenario-based modelling study
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Date
2025-09
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PLOS Medicine
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Why was this study done?
• The newly-emergent Clade Ib monkeypox virus (MPXV) can spread more easily between people compared to the previous Clade Ia MPXV, and can be transmitted
through both sexual and non-sexual contacts.
• Immunity from historical smallpox vaccination, which also offered protection against monkeypox, is waning with the ageing of the vaccinated population, increasing the risk of outbreaks in African countries.
• While some countries in Africa began to receive mpox vaccine donations in late 2024, few studies have explored how mpox vaccination could be carried out in Africa, especially for one-time campaigns across sub-Saharan African countries at different time points.
What did the researchers do and find?
• We provided the first assessment of mpox vaccine demand for one-time mass vaccination across sub-Saharan Africa based on transmissibility projections up to year 2050, adjusted for the diminishing smallpox-immunised population.
• The results suggested that as sexual transmission of Clade I MPXV becomes more prevalent, greater vaccination coverage and age-specific targeting would be needed.
• We also found that prioritising high-risk age groups, such as children under 5 years and young adults aged 20–29 years, could reduce disease spread more effectively than distributing vaccines evenly across multiple age groups.
What do these findings mean?
• With increasing Clade I MPXV transmission potential over time and persistent risk of outbreaks, planning one-time mass vaccination campaigns can support effective responses, especially when supplies are limited and multiple countries are affected.
• Where increasing sexual transmission is determined, vaccination strategies should adapt by shifting the priority from young children aged under 5 years to adults aged 20–29 years, which would also requires substantially greater minimum
vaccination coverage to successfully control outbreaks.
• These recommendations were based on information available about how Clade I MPXV was spreading in the Democratic
Republic of the Congo up to December 2024.
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Jin S, Asakura TR, Murayama H, Niyukuri D, Saila-Ngita D, Lim JT, et al. (2025) Vaccination strategies to achieve outbreak control for MPXV Clade I with a one-time mass campaign in sub-Saharan Africa: A scenario-based modelling study. PLoS Med 22(9): e1004726. https://doi.org/10.1371/journal.pmed.1004726