# Optimal deployment of limited vaccine supplies to control mpox outbreaks

## TL;DR

This study explores the best way to use limited MVA-BN vaccines to control mpox outbreaks, considering risk levels and timing of doses.

## Contribution

The study introduces a framework for optimizing vaccine allocation based on risk and timing factors.

## Key findings

- A single dose strategy may avert more cases in high-risk populations if administered recently.
- The optimal strategy depends on the risk level of the subpopulation and the timing of the first dose.
- Two-dose regimens are more effective for long-term protection in lower-risk groups.

## Abstract

Mpox outbreaks in central and East Africa have been declared a public health emergency of international concern by the World Health Organization. Fortunately, real-world effectiveness studies of the MVA-BN vaccine indicate that it has an effectiveness of 74% after one dose, and 82% after two doses against mpox. However, given the very limited availability of vaccines, there remain questions around the optimal deployment of limited MVA-BN doses. In this study, we consider whether more mpox cases might be averted by following the traditional two-dose vaccine regimen (4 week dosing interval), or by giving a single dose of MVA-BN to as many individuals as possible. We find that the optimal strategy depends on (i) the degree to which a subpopulation might be at higher risk of mpox, or severe mpox, and (ii) how long ago the first dose was administered to the most at-risk subpopulation.