Last updated July 12, 2023
General questions
What is mpox?
Mpox is an illness caused by a virus in the orthopox family of viruses, which also includes smallpox. Mpox can be serious for people who get it. People with mpox often get a rash that may be located on the hands, feet, chest, face, mouth, or near the genitals.
What is the risk to the general public?
The risk to most Coloradans is low.
Where has mpox been identified?
Cases of mpox were identified internationally during an outbreak in 2022, including in North America and Colorado.
CDPHE is monitoring mpox activity in Colorado and across the nation. Cases of mpox have decreased in Colorado since the height of the outbreak in August 2022.
How is mpox transmitted?
Mpox can be transmitted in different ways. It can be transmitted from person to person when someone who has mpox has close contact with someone else. Close contact can mean physical contact with the sores, bumps or lesions of someone who has mpox, or through prolonged, face-to-face interactions with someone who has it. Close contact includes sexual contact. The risk of mpox transmission through touching the bed linens or clothing of someone who has mpox is considered low. Most cases in the United States have been acquired through close physical contact with someone who has mpox. Brief interactions without physical contact are unlikely to result in getting the virus.
What are the symptoms of mpox?
People with mpox get a rash that could be on or near the genitals, as well as other areas like hands, feet, chest, face, or mouth. Mpox can look like syphilis, herpes, blisters, or even acne. For some people, mpox can feel like the flu at first. Early symptoms can include fever, headache, muscle aches, swollen lymph nodes, and exhaustion. Most people get a rash or skin bumps one to three days after they first start feeling symptoms, but some people develop flu-like symptoms later or not at all.
How long does illness from mpox last?
Most people recover from mpox within two to four weeks.
Is mpox dangerous?
Mpox can be serious, but most people recover fully. In most cases, mpox will resolve on its own without specific treatment after two to four weeks. Treatment is available for people at higher risk or those with severe disease. The version of mpox spreading in recent outbreaks has a fatality rate of less than 1%.
Are some people at higher risk for mpox?
Anyone can get mpox. The virus does not discriminate against any group. In context of recent outbreaks, men who have sex with men may be at higher risk for contracting mpox, based on recent data. Transgender people and gender-diverse people may also be at higher risk.
What should I do if I think I may have mpox?
Anyone with symptoms of mpox should contact a health care provider as soon as possible. Avoid close contact with others. Wear a mask, cover any skin lesions or sores, and notify the provider before you arrive to seek care. Your provider may prescribe you antiviral treatment to help you recover.
Some providers offer testing for people who have symptoms of mpox. Visit CDPHE’s mpox testing page for more information about getting tested for mpox.
What should I do if I may have been exposed to someone with mpox?
If you think or know you have been exposed and have not received two doses of Jynneos vaccine, contact a health care provider as soon as you can to ask about vaccination. Mpox vaccines can help keep you from getting sick if you get vaccinated within four days of exposure. If you get the vaccine between four and 14 days after exposure, it can help prevent severe illness and hospitalization. Visit CDPHE’s mpox vaccine page to learn more about where to find a free mpox vaccine.
Am I entitled to paid time off from work while I am isolating with mpox?
In Colorado, all employers must provide one hour of paid leave per 30 hours worked, up to 48 hours per year. Employers are not required to provide supplemental public health emergency leave for mpox. For more information, visit the Colorado Department of Labor and Employment’s website Paid Sick Leave under the Colorado Healthy Families and Workplaces Act (HFWA).
Testing
Who should get tested for mpox?
Public health experts recommend mpox testing for people who have a new rash, lesions, or sores with pus and could have had close contact with someone who had mpox. People without a rash, lesions, or bumps cannot be tested.
How do health care providers test for mpox?
The test for mpox involves swabbing a skin lesion, bumps, or rash. Providers send the swab into a lab for testing to detect viruses in the orthopoxvirus genus.
How long does it take to get results from mpox testing?
Typically, you should receive your test result within 48 hours. You will receive your result from the same health care provider that performed your test. In the event that the provider cannot reach you, or if additional information is needed, public health may also reach out.
Where can I get tested for mpox?
Visit our mpox testing page for an up-to-date list of providers that are able to collect samples for mpox testing. Many individual primary care and other health care providers are able to collect samples for mpox testing. If you are looking for an mpox test, contact your regular health care provider first to find out if they offer testing.
What should I do with my mpox test results?
If you test positive, stay home, avoid contact with others, and cover any skin lesions or sores. Your provider or public health will give you instructions how to isolate away from other people until you feel better. Most people recover from mpox within two to four weeks. Antiviral medication is available. Talk to a health care provider, especially if you have an underlying medical condition that you think might put you at increased risk for severe illness.
If you have been diagnosed with mpox, it’s important to notify your close contacts that they may have been exposed to mpox as soon as possible so they can watch for signs and symptoms, get tested, and isolate if they have symptoms. They should consider getting vaccinated if exposed less than 14 days ago, ideally within four days of exposure. By letting your close contacts know they may have been exposed to mpox, you are helping to protect them and everyone around them.
It is likely that public health will reach out to you to review isolation guidelines, provide more information about your illness, and determine if you had any close contacts who might be recommended for vaccination.
If you test negative, contact a health care provider to discuss other possible causes of your symptoms.
Do I need to get an mpox test to get the mpox vaccine?
No. The mpox vaccine can be used to prevent or lessen symptoms of illness in people who were exposed to a case and receive the vaccine within 14 days of exposure, as well as people who are at risk of exposure. People who believe they have been exposed to mpox and have symptoms should visit a health care provider to find out if they need to be tested.
Vaccine
What kind of vaccine is available for mpox?
The vaccine for mpox is called Jynneos. Jynneos is fully FDA-approved.
How many doses of the vaccine do I need?
People who get vaccinated with Jynneos need two doses of the vaccine 28 days apart. People should receive their second dose even if it has been longer than 28 days since their first dose. At this time, anyone who has received two doses of Jynneos is not recommend to receive additional doses.
Who should get vaccinated against mpox?
Jynneos vaccines are available at many locations in Colorado, and there are no longer specific eligibility criteria for mpox vaccination — anyone who thinks they may be at risk of exposure to mpox can get vaccinated. Public health specifically recommends vaccination for people who may be at higher risk based on data from recent outbreaks, including:
- Anyone who has had close physical contact with someone who has mpox in the last 14 days.
- Anyone who:
- Has multiple or anonymous sexual partners, or
- Has close physical contact with other people in a venue where anonymous or group sex may occur, or
- Was diagnosed with gonorrhea or syphilis in the past six months, or
- Is living with HIV, or
- Already uses or is eligible for HIV PrEP (medication to prevent HIV, e.g. Truvada or Descovy or Apretude), or
- Engages in commercial and/or transactional sex (e.g. sex in exchange for money, shelter, food, and other goods or needs).
- Anyone identified by public health as a known high-risk contact of someone who has mpox.
- Anyone whose sexual partner identifies with any of the above scenarios.
- Anyone who anticipates experiencing any of the above scenarios.
Anyone who meets these criteria can talk with a health care provider to learn more about whether vaccination is right for them. A conversation with a health care provider is not required to get vaccinated.
The Jynneos vaccine is fully licensed for people 18 years of age and older, and available under Emergency Use Authorization (EUA) for people under 18 years of age who are at high risk for mpox exposure.
Some children may benefit from alternative options for post-exposure prophylaxis. Data shows that the Jynneos vaccine may not work well to protect infants under the age of six months from mpox illness. In these cases, public health will consult with Centers for Disease Control and Prevention and the child’s primary care provider to discuss available options.
CDPHE-hosted clinics can vaccinate eligible people aged 15 years and older. Parents and guardians of children younger than 15 years who may need to be vaccinated should contact their health care provider or local public health agency. Parental/guardian consent is required to administer the Jynneos vaccine to anyone under the age of 18 years. In addition to parental/guardian consent, minors aged 15 to 17 must also sign a formal agreement to receive the vaccine.
How do I make a vaccine appointment?
Visit CDPHE’s mpox vaccine page to learn more about where to find a free mpox vaccine.
Is the vaccine free? Do I need insurance?
The mpox vaccine is free. No ID, insurance, or out-of-pocket payment is needed to get vaccinated.
How does the vaccine against mpox work?
Jynneos contains small amounts of a live, non-replicating virus called the Vaccinia virus. This virus is in the same family as mpox and smallpox. The vaccine teaches your body how to fight off the Vaccinia virus. Because this virus is very similar to mpox, your body will also be better able to fight off mpox after you have been vaccinated.
How effective is the vaccine?
Studies on the effectiveness of the Jynneos vaccine suggest completing a two-dose series may be more than 80% effective at preventing infection or severe illness. Data shows people may have some protection as early as two weeks after their first vaccine dose, and protection is stronger after completion of the two-dose Jynneos vaccine series.
People who are vaccinated should continue to avoid close, skin-to-skin contact with someone who has mpox.
When do I need to get the vaccine?
If you think you have been exposed to mpox, get vaccinated as soon as possible. The vaccine can help keep you from getting sick at all if you receive it within four days of exposure to the mpox virus. If you get the vaccine between four and 14 days after exposure, it can help prevent severe illness but may not completely prevent infection.
If you haven’t been exposed, but expect to be at risk of exposure in the future, try to schedule your first dose of the vaccine at least one month before you anticipate being at higher risk for exposure.
Can I get my mpox vaccine at the same time as other vaccines?
CDC guidance advises that the Jynneos vaccine can typically be administered at the same time as other vaccines, at different sites on the body if possible.
However, people who would like to get vaccinated against mpox and receive a COVID-19 vaccine within four weeks of each other should talk to a health care provider. People who recently received a COVID-19 vaccine should not wait to receive Jynneos if they had a recent mpox exposure. People who recently received a mpox vaccine may consider waiting up to four weeks to receive a COVID-19 vaccine — especially young men, as they may be at higher risk of very rare side effects such as myocarditis and/or pericarditis following vaccination with a COVID-19 vaccine. Contact a health care provider if you have questions.
What are the side effects of the vaccine?
The most common side effects are pain, redness, swelling, hardness, and itching at the injection site. Side effects can also include soreness, headache, fatigue, nausea, and chills.
How is the vaccine administered?
The Jynneos vaccine can be given either intradermally or subcutaneously, depending on a person’s age, preference, and the level of vaccine supply. Intradermal vaccines are given between layers of the skin. This should produce a noticeable pale bump on the skin, also known as a “wheal.” Using the intradermal administration method increases the number of available vaccine doses up to five-fold. Subcutaneous doses of Jynneos are given in the fatty tissue under the skin. People younger than 18 years of age and people who have a history of forming keloid scars should receive the vaccine subcutaneously.
Do I have to receive my dose intradermally?
No. CDPHE strongly recommended intradermal vaccination for a time in 2022 to increase the number of available vaccine doses in Colorado when the federal supply of Jynneos vaccine was extremely limited. Now, more vaccines are available throughout the state, and people may choose to receive subcutaneous or intradermal doses.
Are intradermal doses as effective as subcutaneous doses?
An analysis from the recent outbreak in 2022 suggested there was no difference in vaccine effectiveness between subcutaneous and intradermal administration.
Do intradermal doses have different side effects than subcutaneous doses?
Yes, the side effects are slightly different for intradermal doses. People who receive an intradermal dose may be more likely to see a raised bump at the spot where they got the vaccine than people who receive a subcutaneous dose. This bump may be discolored, painful, and itchy. The pain and itch usually go away on their own after a few days. Some people may have a noticeably discolored spot where they received the vaccine for weeks or months after vaccination. This discoloration is normal and will likely go away on its own over time.
Is an intradermal dose a full dose?
Yes. The intradermal method requires less of the vaccine to work, but it is still considered a full dose. Intradermal administration gives as much protection from mpox as subcutaneous administration, the way the vaccine is usually administered. Instead of thinking of it as a “lower” dose, think of it as the right dose for this method.
What if I got my first dose subcutaneously?
If a person received their first dose subcutaneously, the second dose may be administered intradermally, except for people under the age of 18 years or with a history of keloid scarring. They should receive their second dose subcutaneously as well.
Can I receive an intradermal vaccination in a different body part than the forearm?
Yes. According to CDC’s administration guidance, intradermal vaccination can be administered in one of three locations on the body. While the forearm is the preferred location, you may get the vaccine in the upper back just below your shoulder blade or on the outside of your upper arm near your deltoid muscle if you prefer.