Demographic Disparities in Mpox Vaccination Series Completion, by Route of Vaccine Administration - California, August 9, 2022-March 31, 2023

MMWR Morb Mortal Wkly Rep. 2023 Jul 28;72(30):827-832. doi: 10.15585/mmwr.mm7230a4.


In August 2022, the Food and Drug Administration authorized JYNNEOS vaccine (modified vaccinia Ankara vaccine, Bavarian Nordic), a 2-dose series used for the prevention of Monkeypox virus infection, to be administered via a dose-sparing intradermal route, in addition to the previously authorized subcutaneous route. The California Department of Public Health investigated whether demographic disparities in vaccination series completion varied by route of administration of the recipient's first dose. Among California residents who received their first dose during August 9, 2022-March 31, 2023, a total of 59.8% received a second dose. Series completion was highest among non-Hispanic White persons (64.1%), persons aged ≥65 years (72.6%), and adults with male sex assignment at birth (62.1%); series completion was lowest among non-Hispanic Black or African American persons (51.3%), persons aged 18-24 years (42.9%), and adults assigned female sex at birth (42.8%). When the first dose was received by subcutaneous administration, overall series completion was 58.8% compared with 60.2% when the first dose was administered intradermally. Odds of series completion across all race and ethnicity groups, persons aged 18-64 years, community health conditions, and persons assigned male sex at birth were not greater when the first dose was administered subcutaneously compared with intradermally. Intradermal use of JYNNEOS vaccine did not lower overall 2-dose series completion rates. Continued efforts are needed to ensure persons at risk for Monkeypox virus infection receive both recommended doses.

MeSH terms

  • Adult
  • California / epidemiology
  • Ethnicity
  • Female
  • Healthcare Disparities
  • Humans
  • Infant, Newborn
  • Male
  • Mpox (monkeypox)*
  • Smallpox Vaccine*
  • Vaccination


  • Smallpox Vaccine