Should Mpox Vaccination Be Offered to More Children and Adolescents
May 29, 2025
As mpox persists globally, new research published in The Lancet Infectious Diseases reinforces the JYNNEOS vaccine’s efficacy in mitigating disease severity, particularly in preventing the progression to disseminated lesions. With over 720,000 doses administered across seven African nations, and updated U.S. CDC vaccination guidelines targeting high-risk groups, coordinated efforts are critical. Yet, disparities persist: vaccine protection is significantly lower among HIV-positive individuals with weakened immunity. With mpox posing rising risks to children via household transmission, expanding vaccine access, especially in Africa where clade Ib is surging, is imperative to halt further spread and reduce global health inequities.
The continued global mpox outbreak, driven by clade IIb and clade Ib variants, has infected over 100,000 people since May 2022 and shows no sign of abating. As ten African countries now report community transmission of clade Ib MPXV, the need for widespread and equitable access to vaccination is urgent. A recent Lancet Infectious Diseases study confirms that Bavarian Nordic’s JYNNEOS vaccine—already deployed in over 720,000 doses across seven African nations—significantly reduces the risk of severe mpox symptoms, including disseminated lesions and hospitalization.
Encouragingly, JYNNEOS is effective regardless of whether individuals receive one or two pre-exposure doses. Among HIV-negative individuals, the vaccine reduces the risk of lesion spread by 67%; among HIV-positive individuals with high CD4 counts, it still confers 45% protection. However, the diminished efficacy in immunocompromised populations underscores the importance of targeted strategies, including post-exposure prophylaxis and early detection.
As the U.S. CDC updates its vaccination guidelines to encompass a broader range of high-risk individuals—including those with recent STIs, multiple sexual partners, or exposure in public venues—similar public health interventions are needed in African countries currently under-resourced in diagnostics and vaccine distribution. CDC modeling also warns of increasing vulnerability among children, who primarily contract mpox from infected household members, unlike adolescents, where sexual transmission dominates.
With both clade I and II viruses preventable by vaccination, it is vital to ensure that the protection JYNNEOS offers is not limited to wealthy nations. The disease’s potential to evolve, combined with inequities in vaccine access, threatens global containment efforts. Expanded manufacturing, global stockpiling, and public education are crucial. The message is clear: mpox is a vaccine-preventable disease—global access must reflect that reality.