Vaccination Equity for Prevention of Mpox

In the United States the JYNNEOS vaccine has FDA approval for the prevention of mpox and smallpox. The vaccine is given either subcutaneously (under the skin) or intradermally (in between the layers of the skin). Unvaccinated people have a 14 times higher risk of monkeypox disease than those who got vaccinated.

Subcutaneous and intradermal injection of vaccine can both cause redness, swelling, soreness and itchiness at the injection. However, these reactions are usually worse and last longer with intradermal administration.

In one study, almost all people receiving the vaccine intradermally had more than an inch of redness and swelling, and about one-third of them had mild redness or discoloration at the injection site lasting six months or longer.

A person who presents for their second JYNNEOS vaccine dose who is still experiencing erythema or induration at the site of intradermal administration of the first vaccine dose (e.g., the forearm) should have the second dose administered either subcutaneous or intradermally. If intradermal dose repeated then use one of the following methods:

• contralateral forearm
• upper back below the scapula
  
• at the deltoid