Mpox Vaccine

Quicklinks

1. Mpox Vaccine Enrollment
2. Mpox Provider Overview
3. Reporting Requirements
4. Storage & Handling
5. Ordering & Inventory
6. Administration Resources/Clinical Considerations
7. Advisories
8. Contact Us
9. Resources

1. Mpox Vaccine Overview & Enrollment Process

Patient Eligibility Guidance

Any patient who feels that they are at risk for coming into contact with mpox can be vaccinated. They do not need to meet any further eligibility criteria.

However, outreach should continue to those who are most at risk. This includes sex workers of any sex or gender, and gay, bisexual, transgender, or other men who have sex with men, or non-binary persons who meet the following criteria:

• Have had multiple or anonymous sex partners in the last 14 days
• Have had any newly diagnosed STI in the past 12 months, including gonorrhea, chlamydia, early syphilis, or HIV
• Have recently attended or plan to attend any venue where anonymous sex or sex with multiple partners will occur (e.g. saunas, bathhouses, sex clubs, sex parties) in the next 30 days
• Have met recent partners or plan to meet new partners in the next 30 days through social media platforms (such as Grindr, Tinder or Scruff), or at clubs, raves, sex parties, saunas

If you see patients who are at a higher risk of mpox infection, please consider becoming a JYNNEOS vaccine provider and help stop the spread of mpox infection!

The Public Readiness and Emergency Preparedness Act (PREP) now includes liability coverage for providers, including pharmacists, for countermeasures against smallpox (variola virus), mpox virus, and other orthopoxviruses. Read the mpox PREP FAQ. Sites are not required to see non-patients, but we do encourage providers to offer walk-in vaccine availability and if possible, vaccinate non-patients.

Note: this vaccine is administered intradermally, and may require some additional training of staff to administer appropriately. Please complete the enrollment form if your site is interested in ordering JYNNEOS vaccine.

Enrollment Check List

To enroll as a mpox provider in Philadelphia, you’ll need to complete the following steps:

• Submit the Enrollment Form
• Review the CDC Provider Agreement and adhere to all requirements
• Identify two vaccine coordinators. They will need to complete the Online Ordering and the Storage and Handling training
• Setup your vaccine storage units
• Setup reporting for vaccines administered

Once these steps are completed, your site will be able to order mpox vaccine for your patients. If your site sees patients who are eligible for the mpox vaccine, we encourage you to enroll as a provider today!

Go back to quicklinks.

2. Mpox Provider Overview

Watch the recorded video below to learn how to make mpox vaccine requests, submit temperature logs, and correctly complete your mpox reconciliation. Timestamps are recorded in the videoʼs Youtube description. You can download the slides from the updated presentation here.

Go back to quicklinks.

3. Reporting Requirements

Administered mpox vaccine must be reported to the PDPH PhilaVax Immunization Information System (IIS) within 24 hours.

HL7 Reporters 

• Confirm that the CVX code is mapped internally allowing for both specifications 
• Trigger two test messages from each location at which you plan to administer the mpox vaccine 

• • Send test messages to training environment showing both specifications 

• Once HL7 test messages have been approved by the IIS team, you will report mpox vaccine administration in real time 

Flat File Reporters: Secure File Transport Portal (sFTP) 

• Confirm that the CVX code is mapped internally allowing for both specifications 
• Upload a flat file to your designated sFTP account with mpox vaccine administration data  

• • A file must be uploaded each day that you administer the vaccine 

• Flat File
  • Flat File should meet these standards.

• • Flat File reporting template: Flat File Mpox Vaccine Reporting Template 

Go back to quicklinks.

4. Storage & Handling

As a mpox vaccine provider you are required to comply with our storage and handling requirements.

• Vaccine will be transported to your site at refrigerated vaccine temperatures 36 – 46°F (2-8 C) with a beyond use date (BUD) label indicating the date it must be used by. Thawed JYNNEOS vaccine should not be refrozen. JYNNEOS can be stored at refrigerated temperatures for 8 weeks. (Note: this differs from the page insert that come with the vaccine. More information can be found in the attached letter from the manufacturer).
• JYNNEOS vaccine cannot be stored at room temperature at any time. Immediately replace the punctured vial in the refrigerator.
• Once the vial is punctured, you must discard it after 8 hours.
• Temperature data must be reported every 28 days, when requesting additional dose of mpox vaccine, or whenever there is an out-of-range temperature. File should be emailed to TempCheck@phila.gov. If your site is using a PDPH provided DDL the files will also need to be uploaded into PhilaVax.
  • All providers must complete our Storage and Handling DDLTraining by watching this video and then completing this quiz.
  • You can find all of our vaccine storage and handling videos stored on our YouTube channel.

Go back to quicklinks.

5. Ordering & Inventory

Ordering Instructions 

• Please use this form to request quantities of JYNNEOS vaccine for intradermal administration at your practice.
• For your vaccine request to be approved you must upload your temperature logs to PhilaVax or email them to tempcheck@phila.gov. Before submitting your order request you must submit a reconciliation. All orders should be submitted on Mondays by 5pm.
• If your request is approved, you can expect to receive JYNNEOS Wednesday or Thursday following your request date. Please make sure you have a contact available to receive the vaccine at your practice.
• Please note: Your allocation of JYNNEOS from PDPH will include additional vials to account for individuals at risk for developing keloid scars and those under the age of 18 that may need a subcutaneous dose. Additional vials will also be provided to compensate for the fact that most provider are not getting 5 ID doses per vial.
• If you have questions about accessing JYNNEOS vaccine, email vaccines@phila.gov.

Ordering Form

Use our online ordering form to request MPX vaccine.

Wastage  

• Wastage should be reported weekly. 
• Because the vaccine is licensed for one dose per vial, wastage will be considered as any wastage of a full vial of vaccine for any reason. If you administer at least one dose, using either ID or SubQ administration, you do not need to report wastage on that vial.   
• Guide: How to add Jynneos vaccine wastage    
• What counts as wastage for MPOX
• Video: How to add vaccine wastage to PhilaVax   

Managing Vaccine Inventory: 

• A mpox inventory has been set-up in PhilaVax to track Jynneos doses in sites’ inventory. A reconciliation must be completed weekly (every 7 calendar days) 
• Inventory will reflect the number of vials currently on hand, not the number of doses. 
• Reconciliation Quick Guide
• Accepting Shipments in PhilaVax
• Inventory & Administration Reporting Guide
  

Go back to quicklinks.

6. Administration Resources/Clinical Considerations

Dosage, Administration and Route 

JYNNEOS vaccine is licensed as a series of two doses administered 28 days (4 weeks) apart.

The standard regimen involves a subcutaneous (SubQ) route of administration with an injection volume of 0.5mL. The standard regimen is the FDA-approved dosing regimen. Since August 9, 2022, the standard regimen has been authorized for people aged <18 years under an Emergency Use Authorization.

In the context of the current national Public Health Emergency (PHE), an alternative regimen may be used for people age ≥18 years under an Emergency Use Authorization beginning August 9, 2022. The authorized alternative regimen involves an intradermal (ID) route of administration with an injection volume of 0.1mL. This approach could increase the number of available JYNNEOS vaccine doses by up to five-fold. Results from a clinical study showed that the lower intradermal dose was immunologically non-inferior to the standard subcutaneous dose.

Intradermal administration involves injecting the vaccine superficially between the epidermis and the hypodermis layers of the skin, typically of the inner side of the forearm.  Watch this video on administering JYNNEOS intradermally below. You can find additional resources, including images, here.

Intradermal JYNNEOS administration can be considered for most adults ages 18 years and older. Exceptions include people with a history of developing keloid scars. It is not required to observe patients after vaccination.

• View the CDC recommendations on administration.
  • View the CDC’s Intradermal Vaccine Preparation and Administration Summary. 

• JYNNEOS Vaccine Dose Tracker
• Video: CDC Intradermal administration overview

Vaccine Administration Deviations and Errors

Detailed interim recommendations related to the correct administration of MPX vaccine, including when a dose needs to be repeated or a VAERS report must be submitted are posted on the CDC website. Check back regularly for updates.

Go back to quicklinks.

8. Contact Us

Have a problem or concern? Need help ordering or managing vaccine? The Philadelphia Immunization Program is here to help!

If you have questions regarding any of the following issues, contact the Philadelphia Immunization Program member listed. Don’t see the right person to contact? Visit our staff page or contact vaccines@phila.gov for assistance.