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Preparedness and priority research to tackle the mpox outbreak response

Nature Medicine volume 31, pages 14–15 (2025)Cite this article

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The mpox outbreak in the Democratic Republic of the Congo and neighboring countries has become the worst on record, with a recent escalation of cases and deaths. This situation prompted the Africa Centres for Disease Control and Prevention and the World Health Organization to declare mpox a continental and global health emergency in August 2024 (ref. 1). As of now, cases of mpox from both clade I and II have been reported in several African countries and in other regions, including Asia, Europe and North America. Two smallpox vaccines, MVA-BN (Bavarian Nordic) and LC16m8 (KM Biologics), have been authorized or approved for emergency use by several countries for use against mpox; MVA-BN has been prequalified by the World Health Organization2. ACAM2000 (Emergent BioSolutions) is another smallpox vaccine with authorization for use against mpox, originally developed for use in bioterrorism emergencies, that could also be employed in response to the mpox outbreak, provided safety concerns are adequately assessed.

Although the MVA-BN and LC16m8 vaccines have been shown to be safe, their efficacies in immunosuppressed individuals (for example, people living with human immunodeficiency virus) require further investigation3. Additional studies are also needed to evaluate potential adverse effects during pregnancy and in pediatric populations4. Given that mpox can lead to severe complications, particularly in children, pregnant women and immunocompromised individuals, there is an urgent global need for a highly effective and well-tolerated mpox vaccine. Building on contributions by the Coalition for Epidemic Preparedness and Innovation (CEPI) during the COVID-19 pandemic and the insights gained during that time, CEPI has been actively investing in global epidemic preparedness against emerging infectious diseases, including mpox.

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Acknowledgements

The authors thank colleagues at the CEPI, particularly N. Lurie and R. Best, for their dedication to mpox activities; P. Spencer, quality manager, V. Zala, project manager, and J. Hutchens, project coordinator, at the CEPI, for their support throughout the mpox initiative; and J. Rogers, senior communications and advocacy manager at the CEPI, for her insightful feedback on this manuscript.

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Authors and Affiliations

  1. Coalition for Epidemic Preparedness and Innovation, Washington, DC, USA

    Ali Azizi

  2. Coalition for Epidemic Preparedness and Innovation, London, UK

    Kristine Rose, Gathoni Kamuyu & Deborah Ogbeni

  3. Coalition for Epidemic Preparedness and Innovation, Oslo, Norway

    Valentina Bernasconi

Authors
  1. Ali Azizi
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  2. Kristine Rose
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  3. Gathoni Kamuyu
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  4. Deborah Ogbeni
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  5. Valentina Bernasconi
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Corresponding author

Correspondence to Ali Azizi.

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All work discussed herein was funded by the CEPI. The authors do not receive any royalties, licenses, stock options or other financial benefit.

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Azizi, A., Rose, K., Kamuyu, G. et al. Preparedness and priority research to tackle the mpox outbreak response. Nat Med 31, 14–15 (2025). https://doi.org/10.1038/s41591-024-03367-y

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