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Abstract

Background

In 2022 and 2023, a global outbreak of mpox affected mostly gay, bisexual and other men having sex with men (GBMSM). Outbreak control in the Netherlands included isolation, quarantine, post-exposure prophylaxis vaccination and primary preventive vaccination (PPV).

Aim

We describe the course of the outbreak, the vaccination programme, vaccine effectiveness (VE) of full vaccination against symptomatic disease, and trends in behaviour to generate hypotheses about factors that influenced the outbreak’s decline.

Methods

In this observational study, we collected data from public health services on notified cases, number of PPV invitations and PPV doses administered. We calculated PPV uptake and coverage. Trends in behavioural data of GBMSM visiting sexual health centres were analysed for all consultations in 2022. We estimated VE using the screening method.

Results

Until 31 December 2023, 1,294 mpox cases were reported. The outbreak peaked in early July 2022 and then declined sharply. PPV started on 25 July 2022; in total 29,851 doses were administered, 45.8% received at least one dose, 35.4% were fully vaccinated. The estimated VE was 68.2% (95% CI 4.3–89.5%). We did not observe an evident decrease in high-risk behaviour.

Discussion

It is unlikely that PPV was a driver of the outbreak’s decline, as incidence started to decline well before the start of the PPV programme. The possible impact of behavioural change could not be demonstrated with the available indicators, however, the data had limitations, hampering interpretation. We hypothesise that infection-induced immunity in high-risk groups was an important factor explaining the decline.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2024-05-23
2024-06-17
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2024.29.21.2300608
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Factors potentially contributing to the decline of the mpox outbreak in the Netherlands, 2022 and 2023
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Manon+R+Haverkate&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Haverkate Manon R</a>, <a href="/search?value1=Inge+JM+Willemstein&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Willemstein Inge JM</a>, <a href="/search?value1=Catharina+E+van+Ewijk&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van Ewijk Catharina E</a>, <a href="/search?value1=Philippe+CG+Adam&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Adam Philippe CG</a>, <a href="/search?value1=Susan+J+Lanooij&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lanooij Susan J</a>, <a href="/search?value1=Petra+Jonker-Jorna&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jonker-Jorna Petra</a>, <a href="/search?value1=Colette+van+Bokhoven&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van Bokhoven Colette</a>, <a href="/search?value1=Gini+GC+van+Rijckevorsel&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van Rijckevorsel Gini GC</a>, <a href="/search?value1=Elske+Hoornenborg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hoornenborg Elske</a>, <a href="/search?value1=Silke+David&option1=author&noRedirect=true" class="nonDisambigAuthorLink">David Silke</a>, <a href="/search?value1=Liesbeth+Mollema&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mollema Liesbeth</a>, <a href="/search?value1=Margreet+J+te+Wierik&option1=author&noRedirect=true" class="nonDisambigAuthorLink">te Wierik Margreet J</a>, <a href="/search?value1=Jente+Lange&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lange Jente</a>, <a href="/search?value1=Eelco+Franz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Franz Eelco</a>, <a href="/search?value1=Hester+E+de+Melker&option1=author&noRedirect=true" class="nonDisambigAuthorLink">de Melker Hester E</a>, <a href="/search?value1=Eline+LM+Op+de+Coul&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Op de Coul Eline LM</a>, <a href="/search?value1=Susan+JM+Hahn%C3%A9&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hahné Susan JM</a></span>. Factors potentially contributing to the decline of the mpox outbreak in the Netherlands, 2022 and 2023. <a href="/content/ecdc">Euro Surveill.</a> 2024;29(21):pii=2300608. <a href="https://doi.org/10.2807/1560-7917.ES.2024.29.21.2300608" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2024.29.21.2300608</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 03 Nov 2023;&nbsp;&nbsp; <span class="generated">Accepted</span>: 18 Mar 2024 </span> </p>
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