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Modeling Vaccination Approaches for Mpox Containment and Mitigation in the Democratic Republic of the Congo
26 Pages Posted: 18 Mar 2024
More...Abstract
Background: Mpox was first identified in the Democratic Republic of the Congo (DRC) in 1970. In 2023, a historic outbreak of mpox occurred in the country, continuing into 2024. Over 14,000 cases and 600 deaths were reported last year alone, representing a major increase over previous outbreaks. The modified vaccinia Ankara (MVA) vaccine (brand names; JYNNEOS, Imvamune, Imvanex) was used in the 2022 mpox outbreak in the US and Europe. However, vaccination has not been made available in the DRC.
Methods: A dynamic transmission model was used to simulate mpox transmission in the DRC, stratified by age (<5, 5-15, >15 years of age) and province. The model was used to simulate potential vaccination strategies, varying by age and region (endemic provinces, non-endemic provinces with historic cases, all provinces) assessing the effect the strategies would have on deaths and cases in an epidemic year similar to 2023. In addition, we estimated the number of vaccine doses needed to implement each strategy.
Results: Without vaccination, our model predicted 14,500 cases and 700 deaths from mpox over 365 days. Vaccinating 80% of all children <5 in endemic regions led to an overall reduction in cases of 21% and a reduction in deaths of 29%, requiring 10×5 million vaccine doses. Vaccinating 80% of all children <5 in all regions led to a reduction in cases of 23% and a reduction in deaths of 29%, requiring 33×1 million doses. Vaccinating 80% of children <=15 in endemic provinces led to a 59% reduction in cases and a 57% reduction in deaths, requiring 40×7 million doses.
Conclusions: When resources are limited, vaccinating children either <=15 or <5 years in endemic regions of DRC would be the most efficient use of vaccines. Further research is needed to explore long-term effects of either a one-time or recurrent vaccination campaign.
Funding: This work was supported by the International Mpox Research Consortium (IMReC) through funding from the Canadian Institutes of Health Research and International Development Research Centre (grant no. MRR-184813); Department of Defense, Defense Threat Reduction Agency, Monkeypox Threat Reduction Network grant #HDTRA1-21-1-0040; and USDA Non-Assistance Cooperative Agreement #20230048.
Declaration of Interest: No competing interests.
Keywords: mpox, Democratic Republic of the Congo, vaccination, mathematical modeling
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