Fig. 5: Comparison of vaccine strategies to prevent severe mpox cases.
From: Optimal deployment of limited vaccine supplies to control mpox outbreaks
A The ratio of severe cases averted by using a one-dose strategy compared to a two-dose strategy - based on the vaccine effectiveness observed in the clinical studies4, with no waning of immunity (left, black) or predicted (when the doses are spaced at 4, 26, or 52 weeks) using estimates of immune waning from a model-based meta-analysis4 (right). B The risk threshold (the ratio of risk in the high-risk group compared to the low risk) that favours the switch from the one-dose to the two-dose regimen for severe mpox. The risk threshold predicted from the vaccine effectiveness reported in clinical studies (left, black), and the model-based meta-analysis for vaccine administered at 4, 26, or 52 weeks (right). Panels (A, B) assume a low and relatively constant force of infection. C Generalising to consider a variable force of infection and cumulative incidence of severe mpox, we predict the risk threshold above which administering second doses to a high-risk group will avert more cases than administering a first dose to a lower risk group. The predicted risk threshold in the case of a constant (non-decaying) vaccine effectiveness is given by a black dot. The rectangular bars indicate the range between which the risk threshold must fall when waning of vaccine effectiveness is taken into account and with different dose-spacing. Error bars indicate 95% credible intervals.
