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Mpox vaccination
Who should receive the mpox vaccine?
The Centers for Disease Control and Prevention (CDC) vaccine recommendations state that the mpox, vaccine should be offered to people with the highest potential for exposure to mpox such as:
- Gay, bisexual, and other men who have sex with men, transgender, or nonbinary people who in the past 6 months have had:
- A new diagnosis of one or more sexually transmitted diseases (i.e., acute HIV, chancroid, chlamydia, gonorrhea, or syphilis)
- More than one sex partner
- Sex at a commercial sex venue
- Sex in association with a large public event in a geographic area where mpox transmission is occurring
- Sexual partners of people with the above risks
- People who anticipate experiencing the above risks
Currently, the CDC is not recommending routine immunization against mpox for the general public.
- Gay, bisexual, and other men who have sex with men, transgender, or nonbinary people who in the past 6 months have had:
How should the JYNNEOS vaccine be administered?
The Centers for Disease Control and Prevention (CDC) website includes guidance on how to administer the JYNNEOS vaccine. Please review this web page for information on vaccination schedules and dosing regimens, and to view information, videos, and images on administering the vaccine intradermally and subcutaneously. Administering the vaccine intradermally will allow you to maximize the number of people you can vaccinate.
Use of RWHAP funds for mpox
Now that JYNNEOS is commercially available, can HRSA Ryan White HIV/AIDS Program (RWHAP) funds be used to purchase JYNNEOS?
Yes. RWHAP funds may be used to purchase vaccines for eligible RWHAP clients, including JYNNEOS, in accordance with HRSA HIV/AIDS Bureau Policy Clarification Notice #16-02 Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds (PDF - 172 KB). RWHAP recipients would follow the same purchase and acquisition processes as for other vaccines.
Can HRSA RWHAP funds be used to support mpox testing?
Mpox testing is available through public health and commercial laboratories. Testing done through public health laboratories is free of charge, while there are costs associated with testing at commercial laboratories. RWHAP funds can be used to cover co-pays and deductibles for insured clients and the cost of testing for uninsured clients when a commercial laboratory is used for testing.
How can RWHAP recipients access mpox treatment?
CDC-recommended antiviral treatment should be considered for:
- People with severe mpox disease, such as patients with hemorrhagic disease, a large number of lesions that are confluent, necrotic lesions, severe lymphadenopathy that can be necrotizing or obstructing (such as in airways), involvement of multiple organ systems and associated comorbidities
- People with mpox lesions involving anatomic areas, which might result in serious sequelae, including scarring and strictures
- People who are currently experiencing severe immunocompromise
- Pediatric populations, especially those less than one year of age
- People who are pregnant or breast-feeding
- People with conditions affecting skin integrity such as atopic dermatitis, eczema, herpes simplex virus infections, severe acne, or psoriasis
As there is currently no treatment approved specifically for the mpox virus, RWHAP providers whose patients meet the above criteria should consider enrollment in the clinical trial for tecovirimat (STOMP clinical trial). For patients not eligible for STOMP or who decline to participate, tecovirimat can also be provided under an expanded access protocol.
For more information on mpox treatment, view the CDC Treatment Information for Healthcare Professionals webpage.
Can HRSA RWHAP funds be used to pay for fees associated with mpox vaccine administration and treatment?
Yes. RWHAP funds may be used to pay for fees associated with vaccine administration and treatment of mpox for eligible clients, such as medical visit costs, including personal protective equipment for staff, vaccination supplies, including co-pays and deductibles for insured clients, in accordance with Policy Clarification Notice #16-02 Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds (PDF - 172 KB). RWHAP funds cannot be used for any costs associated with hospitalization or emergency department visits.
For more information, view the August 8, 2022 Program Letter on Mpox Guidance for RWHAP Recipients (PDF - 114 KB).
Can RWHAP recipient staff reassigned to mpox be paid using RWHAP funds?
No. With the expiration of the mpox public health emergency on January 31, 2023, the provision to temporarily reassign state and local public health department or agency personnel funded in whole or in part through programs authorized under the PHS Act (which includes the Ryan White HIV/AIDS Program) for purposes of immediately addressing a public health emergency in the State or Indian tribe during the period of the public health emergency no longer applies.
Use of Health Center Program funds for mpox
Can HRSA Health Center Program funds be used to support mpox testing and treatment?
To the extent feasible given other primary care needs, health centers may use their existing H80 grant funding to support mpox testing and treatment, vaccine administration costs for uninsured patients, as well as additional capacity necessary to address urgent and emergent needs related to the mpox virus.