Analysis of the mpox outbreak in Europe in 2022: vaccination rollout in the most affected countries

Abstract Background The mpox virus spreads through contact with infected material and causes flu-like symptoms and skin lesions. Common in Central and West Africa, a global rise in mpox cases in 2022 was observed, affecting mainly men who have sex with men. Methods The study analysed vaccination policies in the most affected WHO-EURO countries during the mpox outbreak, including the Netherlands, France, UK, Spain, Germany, Belgium, Portugal, and Switzerland. Epidemiological data from May to October 2022 (first wave) were compared. Additionally, the role of EU health institutions in assisting member states in controlling virus spread across the region was examined. Results By the end of May 2022, three countries (The Netherlands, France, and UK) initiated post-exposure vaccination shortly after the first case identification. Portugal, one of the most affected countries, implemented pre-exposure prophylaxis for high-risk groups by September, followed by Switzerland in November. Vaccination access for non-exposed priority groups varied, with France not requiring a medical prescription. EU cooperation in health was pivotal during the outbreak, with vaccines distributed through the EU4Health program budget via HERA to ensure preparedness. However, detailed information remains limited. Conclusions Countries’ responses to the mpox virus outbreak varied significantly, with discrepancies not always aligning with epidemiological data. These differences could stem from various factors, such as behavioural patterns, prior immunisation rates, and neighbouring countries’ policies. However, the unequal access to vaccines across the region underscores existing health disparities, particularly affecting stigmatised populations. Data on immunisation records were notably scarce in most countries, hindering thorough analysis of policy implementation and effectiveness. Additionally, further exploration is warranted into the role of LGBT associations and evidence of stigma surrounding the outbreak. Key messages • The mpox 2022 outbreak in Europe provides an important picture of cross-border health policies and public health responses for future emergences in a European cooperative environment. • Most national authorities provided limited information during the mpox 2022 outbreak; data on immunisation records and vaccine access is pivotal to assess countries’ health policies.