Should all men who have sex with men (MSM) receive the monkeypox (mpox) vaccine?

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Last updated: April 21, 2025View editorial policy

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From the Research

False, not all men who have sex with men (MSM) should automatically receive the mpox vaccine, as the recommendation is based on individual risk assessment rather than sexual orientation alone. The vaccine is currently recommended for those at higher risk of exposure, including MSM who have had multiple or anonymous sexual partners, those with a recent history of sexually transmitted infections, individuals who engage in commercial sex work, or those who have been in venues where sexual contact occurs 1, 2.

Key Considerations

  • The two-dose JYNNEOS vaccine is the preferred option, administered 28 days apart, with maximum protection achieved 14 days after the second dose.
  • Vaccination prioritization is based on risk assessment rather than sexual orientation alone, reflecting public health strategies that focus limited vaccine resources on those most likely to benefit.
  • While mpox has disproportionately affected some MSM communities during recent outbreaks, risk is determined by specific behaviors and exposure likelihood rather than identity.
  • Individuals should consult healthcare providers for personalized risk assessment and vaccination recommendations.

Evidence Summary

  • A study published in 2023 found that approximately 25% of an online sample of men who have sex with men (MSM) with presumed mpox exposure were vaccinated (≥1 dose) 1.
  • Another study published in 2023 found that mpox vaccination is an important public health strategy, particularly for people at risk of infection, including MSM and people living with HIV 2.
  • A systematic review and meta-analysis published in 2024 found that the vaccine effectiveness of 3rd generation mpox vaccines against mpox was 76% (95%CI 64-88%) for 1 dose and 82% (95%CI 72-92%) for 2 doses 3.
  • A study published in 2024 found that determining post-exposure prophylaxis (PEP) effectiveness using real-world data during an outbreak is challenging, and that time to PEP coupled with the observed incubation period resulted in overestimated PEP effectiveness using a conventional method 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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