Issue 1,694: May 24, 2023
Top Stories Pages and Handouts
Featured Resources
Notable Publications
Top Stories

New CDC Health Advisory warns about risk for new mpox cases

On May 15, CDC issued a Health Alert Network (HAN) Health Advisory: Potential Risk for New Mpox Cases. The summary section appears below.

In the United States, cases of mpox (formerly monkeypox) have declined since peaking in August 2022, but the outbreak is not over. The Centers for Disease Control and Prevention (CDC) continues to receive reports of cases that reflect ongoing community transmission in the United States and internationally.... From April 17 to May 5, 2023, a total of 12 confirmed and one probable case of mpox were reported to the Chicago Department of Public Health. All cases were among symptomatic men. None of the patients have been hospitalized. Nine (69%) of 13 cases were among men who had received 2 JYNNEOS vaccine doses. Confirmed cases were in 9 (69%) non-Hispanic White men, 2 (15%) non-Hispanic Black men, and 2 (15%) Asian men. The median age was 34 years (range 24–46 years). Travel history was available for 9 cases; 4 recently traveled (New York City, New Orleans, and Mexico).

Although vaccine-induced immunity is not complete, vaccination continues to be one of the most important prevention measures. CDC expects new cases among previously vaccinated people to occur, but people who have completed their two-dose JYNNEOS vaccine series may experience less severe symptoms than those who have not.

Spring and summer season in 2023 could lead to a resurgence of mpox as people gather for festivals and other events. The purpose of this Health Alert Network (HAN) Health Update is to inform clinicians and public health agencies about the potential for new clusters or outbreaks of mpox cases and to provide resources on clinical evaluation, treatment, vaccination, and testing.

Access the complete CDC HAN Health Advisory.
"The CDC Domestic Mpox Response—United States, 2022–2023" published in MMWR

CDC published The CDC Domestic Mpox Response—United States, 2022–2023 in the May 19 issue of MMWR. A portion of the summary appears below.

After being detected in May 2022, U.S. monkeypox (mpox) cases increased rapidly, peaking in August. Infection was primarily spread by sexual contact among gay, bisexual, and other men who have sex with men....

Rapid adaptation of smallpox preparedness systems and tools, and prioritized communication expertise from HIV prevention programs, were leveraged to reach communities at risk. In 1 year, more than 30,000 cases were reported and >1 million JYNNEOS vaccine doses were administered. Black and Hispanic persons represented 33% and 31% of cases, respectively; 87% of 42 fatal cases occurred in Black persons....

The U.S. risk for future mpox outbreaks remains. Ongoing surveillance, vaccination, and communication are important prevention tools, especially for Black and Hispanic persons in groups at risk.

Access the MMWR article in HTML or PDF.

Related Link

  • MMWR's main page provides access to MMWR Weekly and its companion publications

“Estimated Effectiveness of JYNNEOS Vaccine in Preventing Mpox: A Multijurisdictional Case-Control Study—United States, August 19, 2022–March 31, 2023” published in MMWR

CDC published Estimated Effectiveness of JYNNEOS Vaccine in Preventing Mpox: A Multijurisdictional Case-Control Study—United States, August 19, 2022–March 31, 2023 in the May 19 issue of MMWR. A portion of the summary appears below.

Real-world vaccine effectiveness (VE) estimates for JYNNEOS vaccine against monkeypox (mpox) are limited. To date, no VE estimates by route of administration or for immunocompromised persons have been published....

In this study, adjusted VE was 75% for 1 dose and 86% for 2 doses of JYNNEOS vaccine, indicating substantial protection against mpox, irrespective of route of administration or immunocompromise status....

Persons at high risk for mpox exposure should be vaccinated with the recommended 2-dose JYNNEOS series.

Access the MMWR article in HTML or PDF.

Related Link

  • MMWR's main page provides access to MMWR Weekly and its companion publications

“Effectiveness of JYNNEOS Vaccine against Diagnosed Mpox Infection—New York, 2022” published in MMWR

CDC published Effectiveness of JYNNEOS Vaccine against Diagnosed Mpox Infection — New York, 2022 in the May 19 issue of MMWR. A portion of the summary appears below.

The JYNNEOS vaccine was deployed in a national and state vaccination campaign during the 2022 monkeypox (mpox) outbreak. Postexposure prophylaxis and vaccination of persons at highest risk (primarily men who have sex with men) were prioritized. Evidence of vaccine effectiveness (VE) from controlled studies has been limited....

A comparison of men aged ≥18 years who received a diagnosis of mpox during July 24–October 31 in New York to controls with rectal gonorrhea or primary syphilis, based on systematically collected surveillance data, found adjusted combined 1-dose (received ≥14 days earlier) or 2-dose VE of 75.7%....

These findings support recommended 2-dose JYNNEOS vaccination consistent with CDC and New York State Department of Health guidance.

Access the MMWR article in HTML or PDF.

Related Link

  • MMWR's main page provides access to MMWR Weekly and its companion publications updates its “Ask the Experts” web pages on rabies and varicella vaccines updated two of its popular Ask the Experts web pages: Ask the Experts: Rabies and Ask the Experts: Varicella (chickenpox) as part of its routine review process. This extensive set of clinical questions and answers features CDC vaccination recommendations, clinical considerations, and web links to CDC resources.

  • Ask the Experts: Rabies: Updates reflect the 2022 CDC changes to pre-exposure prophylaxis schedules for individuals at increased risk of exposure to rabies
  • Ask the Experts: Varicella (chickenpox): Updates include current links to ordering information for varicella immune globulin and reflect current epidemiology, including the latest information on the impact of 25 years of routine childhood varicella vaccination’s Ask the Experts main page leads you to 30 web pages on various topics with more than 1,200 common or challenging questions and answers about vaccines and their administration.’s team of experts includes Kelly L. Moore, MD, MPH (team lead), Carolyn B. Bridges, MD, FACP, and Iyabode Beysolow, MD, MPH.

Related Links

Spotlight: resources focused on adolescent vaccination offers many useful materials on adolescent vaccination for professionals and parents.

Resources for Adolescent Vaccination main page highlights all the adolescent educational materials from and partner organizations.

Adolescent Vaccination main page contains the handouts that pertain to adolescent vaccinations.

CDC Schedules main page provides print-ready PDFs of the recommended vaccination schedules for children and adolescents, as well as for adults.

Screening Checklists about Vaccine Contraindications and Precautions main page links you to forms that patients can fill out to expedite assessment of vaccination needs and contraindications.

Give2MenACWY website offers resources to help providers increase teen vaccination and MenACWY booster dose rates.

Journalists interview experts

Journalists seek out experts to help explain vaccines to the public and policy makers. We help the media understand and communicate the complex work vaccinators do. Here is a recent citation.

Vaccines in the news

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination. Pages and Handouts updates its "Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools.” New version dated May 15. reviews and updates the Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools at least monthly, prominently indicating when it was last revised at the top of the page. The checklist was updated a second time in May because CDC released updated documents related to the April 2023 changes to recommendations for bivalent mRNA COVID-19 vaccine administration. When CDC publishes updated standing order templates for the new mRNA vaccine schedules, this checklist will again be updated. The checklist was modified as follows:

  • Removed guidance for Janssen vaccine (all U.S. doses expired May 6)
  • Added interim recommended schedule for bivalent vaccine
  • Removed discontinued summaries of interim clinical considerations and vaccine preparation and administration
  • Added link to FAQs for Interim Clinical Considerations
All COVID-19 vaccination providers should review the checklist regularly. The checklist is posted on's Vaccines: COVID-19 main page to help practices stay up to date.

Related Links

Featured Resources's elegant "Vaccines Save Lives" black enamel pins make thoughtful recognitions for graduations and training completion’s elegantly designed “Vaccines Save Lives” pins are meaningful gifts for people who care about vaccination. The pin makes a refined statement in hard black enamel with gold lettering and edges, measuring 1.125" x 0.75".

The pin features a stick-through-post with the back covered by a round rubber cap that holds the pin securely. A gold metal spring-lock clasp is also provided.

Wear these pins on clothing, uniforms, and white coats to show that you value vaccines.

Click here for "Vaccines Save Lives" pin pricing and ordering information.

Notable Publications

“Epidemiologic Trend of Dengue in U.S. Territories—United States, 2010–2020" published in MMWR

CDC published Epidemiologic Trend of Dengue in U.S. Territories—United States, 2010–2020 in the May 19 issue of MMWR: Surveillance Summaries. The Public Health Action section appears below.

The Advisory Committee on Immunization Practices recommends vaccination with Dengvaxia for children aged 9–16 years with evidence of previous dengue infection and living in areas where dengue is endemic. The recommendation for the dengue vaccine offers public health professionals and health care providers a new intervention for preventing illness and hospitalization in the age group with the highest burden of disease in the four territories.... American Samoa, Puerto Rico, and USVI are all considered endemic areas and persons residing in these areas are eligible for the new dengue vaccine. Persons aged 9–16 years in those jurisdictions with laboratory evidence of previous dengue infection can receive the dengue vaccine and benefit from a reduced risk for symptomatic disease, hospitalization, or severe dengue. Health care providers in these areas should be familiar with the eligibility criteria and recommendations for vaccination to reduce the burden of dengue among the group at highest risk for symptomatic illness. Educating health care providers about identification and management of dengue cases can improve patient outcomes and improve surveillance and reporting of dengue cases.

Access the MMWR article in HTML or PDF.

Related Link

  • MMWR's main page provides access to MMWR Weekly and its companion publications

“Human Papillomavirus Vaccination” published in New England Journal of Medicine

In the May 11 issue, New England Journal of Medicine published Human Papillomavirus Vaccination. The key clinical points appear below.

Human papillomavirus (HPV) is a common sexually transmitted virus. Most HPV infections clear or become undetectable within 1 to 2 years, but persistent infection can lead to cervical, vaginal, vulvar, penile, anal, or oropharyngeal cancer.

Among the oncogenic HPV types, HPV16 is the most likely type to progress to cancer and causes most of the HPV-attributable cancers in women and men.

HPV vaccines target HPV types that cause most HPV-attributable cancers. In clinical trials, vaccines had high efficacy for the prevention of HPV vaccine–type attributable precancers. Protection after vaccination is long-lasting.

In the United States, routine HPV vaccination is recommended at 11 or 12 years of age; vaccination can be started at 9 years of age. Vaccination is recommended through 26 years of age for previously unvaccinated persons. Shared clinical decision making regarding vaccination is recommended for some persons 27 to 45 years of age.

Screening for cervical cancer, according to established guidelines, is recommended regardless of HPV vaccination history.

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Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
    Sharon G. Humiston, MD, MPH
  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
    Marian Deegan, JD
  • Web Edition Managers
    Arkady Shakhnovich
    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
  • Technical Reviewer
    Kayla Ohlde

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