Last updated December 2, 2022
General questions
What is mpox (monkeypox)?
Mpox is an illness caused by a virus in the orthopox family of viruses, which also includes smallpox. Mpox is rare, but it can be serious for people who get it.
What is the risk to the general public?
The risk to the general public is low.
Where has mpox been identified?
Recent cases of mpox have been identified in Europe, Australia, and North America, including Colorado.
State epidemiologists are coordinating across Colorado and with Centers for Disease Control and Prevention to monitor the progression and spread of the virus and learn more about transmission. Coloradans can track Colorado’s mpox cases on our website.
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. Mpox can also be transmitted through touching the bed linens or clothing of someone who has mpox. Recent cases in the United States have been infected through person-to-person contact. Brief interactions without physical contact are unlikely to result in getting the virus.
It’s also possible for people to get mpox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal. However, this has not happened with recent cases in the United States.
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. The version of mpox spreading right now 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 the current outbreak, 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, 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. Visit CDPHE’s mpox vaccine page to learn more about where to find an mpox vaccine.
Can monkeys transmit this virus?
The U.S. cases have occurred through human-to-human transmission. It is possible for the virus to spread through contact with infected animals. There have not been any animal cases of mpox in the United States since 2003.
The virus used to be named monkeypox because the first known outbreak occurred in monkeys, but monkeys are not the typical species to spread the virus now.
All cases in the United States in 2022 have been caused by person-to-person spread and not direct contact with animals.
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. The mpox public health emergency declared by the federal Department of Health and Human Services on August 4, 2022, is not the type that triggers supplemental paid sick leave under Colorado law. 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 was infected.
How do health care providers test for mpox?
The test for mpox involves swabbing a skin lesion. 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. You can also reach out to your normal health care provider to see if they are able to collect samples for mpox 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 for people who might develop severe illness from mpox. Talk to a health care provider if you have an underlying medical condition that you think might put you at increased risk for severe illness.
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 eligible 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. 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 will I get if I’ve been exposed to mpox?
If you meet vaccine eligibility criteria, you can get the fully FDA-approved vaccine called Jynneos. Jynneos is a two-dose vaccine series administered 28 days apart.
Who can request a vaccine appointment?
Those who currently qualify for vaccination are:
- Anyone (any sexual orientation or gender identity) who has had close physical contact with someone who has mpox in the last 14 days.
- Anyone (any sexual orientation or gender identity) 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 (any sexual orientation or gender identity) 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 meets these criteria should talk with a health care provider to determine whether vaccination is right for them.
Due to limited data on the safety and effectiveness of the Jynneos vaccine in children, Coloradans should consult with their child’s primary care provider and/or local public health agency before seeking vaccination for their child, especially for younger children. Shared decision-making between the family, the child’s health care provider, and/or the local public health agency should take into account the level of risk from the child’s exposure to mpox and risk of severe disease.
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 mpox vaccine.
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?
Because mpox is closely related to the virus that causes smallpox, scientists believe smallpox vaccines can protect people from getting mpox. Past data from Africa suggests that smallpox vaccines may be at least 85% effective in preventing mpox in different circumstances. In the current outbreak, CDC reported that preliminary data from 32 states shows that eligible, high-risk populations who did not get vaccinated against mpox were 14 times more likely to get the disease than those who were vaccinated. Data suggests people can be protected as early as two weeks after their first vaccine dose, and protection is expected to be even stronger after completion of the two-dose Jynneos vaccine series.
How soon do I need to get the vaccine?
The sooner an exposed person gets the vaccine, the better. 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.
Can I get the vaccine before I have been exposed?
Yes. Colorado expanded its vaccination criteria to provide protection to Coloradans before they have high-risk exposures to mpox, in addition to those who have a presumed exposure. Vaccination may also be recommended as a preventive measure for some people who are likely to be exposed to the mpox virus at their job, such as certain laboratory workers and health care workers. At this time, most health care and laboratory workers are not recommended to receive the vaccine.
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 or omicron dose within four weeks of each other should talk to a health care provider. People who recently received a COVID-19 vaccine should not delay receiving a Jynneos if they meet current eligibility criteria for vaccination with Jynneos. People who recently received a mpox vaccine may consider waiting up to four weeks to receive a COVID-19 vaccine — especially adolescent or young adult males, 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.
What is intradermal vaccine administration?
Intradermal doses of Jynneos are given between layers of the skin, rather than in the fatty tissue under the skin in a subcutaneous dose. 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.
Are intradermal doses as effective as subcutaneous doses?
A 2015 clinical study showed that intradermal administration produced a similar immune response to subcutaneous administration. People in both study groups responded to vaccination in a similar way, no matter how they received the vaccine.
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.