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Mpox FAQs

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HRSA Mpox Vaccine Distribution Initiative

Can Ryan White HIV/AIDS Program (RWHAP) recipients request from HRSA the JYNNEOS vaccine for mpox?

In August 2022, HRSA was allotted the JYNNEOS mpox vaccine for rapid distribution to RWHAP recipients that met the following criteria:

  • Are dually funded through the HRSA Health Center Program and the RWHAP Part C
  • Serve a significant number of men who have sex with men (MSM) and transgender clients with HIV, based on the most recent RWHAP Client Level Data Services Report
  • Are registered with the Health Partner Order Portal (HPOP) system

RWHAP recipients that met these criteria were invited to request the JYNNEOS vaccine allotted to HRSA.

Will there be other opportunities to request the JYNNEOS vaccine, if our organization is not prepared to request right now? Or, is this a one-time opportunity? If we request the vaccine now, can reorder doses in the future?

At this time, HRSA’s HIV/AIDS Bureau has distributed all of the JYNNEOS vaccines in our allotment. In the event HRSA receives further allocations of the mpox vaccine, we will work with an expanded group of RWHAP-funded clinics to distribute available vaccines.

Will HRSA receive more of the JYNNEOS vaccine for distribution?
At this time [as of October 12, 2022], HRSA does not have additional JYNNEOS vaccine to distribute.
How many boxes of the JYNNEOS vaccine is my organization allowed to request?

HRSA projects that recipients may order up to 50 boxes per recipient, each box contains 20 vials, and each vial can provide approximately up to 5 vaccines through intradermal injections. We will continue to accept orders until our supply is exhausted.

Please order the amount needed to serve your clients at high risk for the mpox. If you request the vaccine, please indicate the number of boxes for a first and second dose. Please make sure to plan and reserve the vaccine supply from your shipment for the second dose of those you vaccinate.

Note, if you request one box with 20 vials, each vial can provide approximately up to 5 doses, so each box can have up to 100 doses of the JYNNEOS vaccine, which means you could provide vaccinations for up to 50 people with the two required doses.

Should we be calculating first and second doses in the number of vials of the JYNNEOS vaccine we request?

Yes. Please consider how much you will need to provide the first and second doses of the JYNNEOS vaccine. Information on the vaccination schedule and dosing is available on the CDC website: JYNNEOS Vaccine.

Can you please provide more information about the data use agreement that is requested?

HRSA will send the data use agreement for signature once it is finalized.

How is the JYNNEOS vaccine shipped? Is a tracking number provided?

The vaccine is sent from Strategic National Stockpile (SNS) in a special insulated container to ensure it stays frozen (-20 degrees Celsius) during shipment. This shipment includes a temperature monitoring device (called a "TempTale"). Please follow the directions for stopping the temperature monitor immediately and verifying that the proper shipping temperature was maintained.

If there is only a stop sign on TempTale, the product is valid for use. If there is a picture of a bell on TempTale, please notify SNS.ops@cdc.gov immediately and SNS will provide instructions on what additional information we need to determine if the vaccine is useable.

When the vaccine is shipped, SNS will send you pictorial diagrams and instructions by email on what to do with the TempTale, as well as other logistical information. There will also be a copy of the instructions inside of the special shipping container. The SNS Operations Center will notify you via email or phone if there are any changes in the estimated time of arrival of the shipment.

Once you have unpacked the vaccine, please promptly ship back the special shipping container and temperature monitor with the provided return shipping label.

Please note, the vaccines will be shipped to only one address per provider. Only a physical address/street address that would be recognized by FedEx, UPS, or a couriers should be provided.

If you submit a vaccine request, it is important to provide a point of contact (POC) who can coordinate the delivery, including their name, phone number, and email address. SNS will coordinate with this POC on the delivery. You will need to provide your receiving hours—if you are only open to receive shipments Monday through Friday, or if your receiving hours are otherwise limited. SNS needs this information so that it can reduce the time the vaccine spends in shipment.

Are ancillary supplies included with the JYNNEOS vaccine shipment?

No, ancillary supplies are not included, but the vaccine is provided free-of-charge.

Is the JYNNEOS vaccine provided by HRSA limited to RWHAP eligible patients or can it be provided to all patients who meet the risk criteria, regardless of their HIV status?

The priority population for these vaccines are RWHAP clients. This includes clients who have been exposed to mpox or who have had recent experiences or risk factors that might make them more likely to have been exposed to mpox (known as post-exposure prophylaxis {PEP or PEP++}), as well as those with the highest potential for exposure to mpox (known as pre-exposure prophylaxis or PrEP). Please view the CDC website for more on who is eligible for the mpox vaccine.

If the clinic has provided care to this group of RWHAP clients, their close contacts and other vaccine-eligible health center patients can receive the vaccine from this allocation, to preserve the health and well-being of the RWHAP client receiving HIV-related care and treatment services.

Please note, if providing the vaccine to non-RWHAP eligible clients, the vaccine administration costs will need to be covered by health center funds or other health care coverage. Vaccine administration costs are covered for RWHAP clients in accordance with Policy Clarification Notice #16-02 Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds (PDF - 172 KB). For more information, please view the August 8, 2022 Program Letter on Mpox Guidance for RWHAP Recipients (PDF - 114 KB).

Who is eligible to receive the mpox vaccine?

People can be vaccinated after known or presumed exposure to someone with mpox (i.e., post-exposure prophylaxis (PEP)), ideally within four days. Additionally, people with certain risk factors and recent experiences that might make them more likely to have been recent exposed to mpox can be considered for vaccination (i.e., expanded post-exposure prophylaxis, PEP++). On September 28, 2022, the CDC expanded eligibility for mpox vaccination so that more people may receive the vaccine before they are exposed to the disease—this is known as pre-exposure prophylaxis or PrEP.

CDC vaccine guidance states that mpox PrEP should be offered to people with the highest potential for exposure to mpox such as:

  • Gay, bisexual, and other men who have sex with men, transgender, or nonbinary people who in the past 6 months have had:
    • A new diagnosis of one or more nationally reportable sexually transmitted diseases (i.e., acute HIV, chancroid, chlamydia, gonorrhea, or syphilis)
    • More than one sex partner
  • People who have had any of the following in the past 6 months:
    • Sex at a commercial sex venue
    • Sex in association with a large public event in a geographic area where mpox transmission is occurring
    • Sexual partners of people with the above risks
    • People who anticipate experiencing the above risks

Currently, the CDC is not recommending routine immunization against mpox for the general public.

Who is authorized to administer the mpox vaccine?

On October 3, 2022, HHS Secretary Xavier Becerra amended the Public Readiness and Emergency Preparedness Act (PREP Act) declaration for smallpox medical countermeasures to expand the categories of providers authorized to administer vaccines and therapeutics against smallpox, mpox, and other orthopoxviruses in a declared emergency.

This declaration expands the types of providers who, with outlined training and supervision, are covered persons authorized to administer vaccines and therapeutics against smallpox (variola virus), mpox, and other orthopoxviruses, in addition to the professionals already licensed or authorized under their state laws to administer these vaccines and therapeutics.

The list of authorized providers now includes:

  • Advanced or intermediate emergency medical technicians

  • Dentists

  • Licensed or certified professional midwives

  • Nurses, advanced practice registered nurses, registered nurses, licensed practical nurses

  • Optometrists

  • Paramedics

  • Pharmacists

  • Pharmacy interns, pharmacy technicians

  • Physicians

  • Physician assistants

  • Podiatrists

  • Respiratory therapists

  • Veterinarians

  • Recently retired healthcare professionals and students of the listed professions

Please view the October 3, 2022 HHS news release for more information.

The amended declaration can be found in the Federal Register and answers to frequently asked questions about the mpox PREP Act declaration can be found on the Administration for Strategic Preparedness and Response (ASPR) website.

We have plenty of doses of the mpox vaccine right now. Should we still request the vaccine from HRSA?

Please only request orders based on how many doses you believe you can use for the patients at greatest risk. We will distribute what we have available based on requests and estimated number of eligible clients as reported in the most recent RWHAP Client Level Data Services Report. We will continue to accept orders until our supply is exhausted.

If our center is getting the mpox vaccine from our health department, do you prefer that we only get it from one source?
No, HRSA does not prefer or require that you receive the vaccine from only one source. We encourage you to continue to coordinate with your state and local health departments so you have enough vaccine to meet the needs of the people you serve who have been exposed to mpox or who are at risk for mpox.
If we have extra of the mpox vaccine, is there a way to distribute to other clinics in need locally, to ensure it gets out as quickly as possible?
For tracking and reporting purposes, recipients should not distribute their allotment of the mpox vaccine to other clinics. However, your organization may consider hosting a vaccine clinic for people in your community or attending a local event to raise awareness about the availability of the vaccine at your organization. Please refer to Policy Clarification Notice #16-02 Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds (PDF - 172 KB) for guidance on using RWHAP funds associated with mpox vaccine administration.
How should the JYNNEOS vaccine be administered?

The Centers for Disease Control & Prevention (CDC) website includes guidance on how to administer the JYNNEOS vaccine. Please review this web page for information on vaccination schedule and dosing regimens, and to view information, videos, and images on administering the vaccine intradermally and subcutaneously. Administering the vaccine intradermally will allow you to maximize the amount of people you can vaccinate.

Also, please be sure to reference the CDC’s JYNNEOS Vaccine Storage and Handling Summary (PDF - 1008 KB).

If our organization requests the JYNNEOS vaccine from HRSA, do we have the option to administer it intradermally or subcutaneously?

The JYNNEOS vaccine can be administered intradermally or subcutaneously. Administering the vaccine intradermally will allow you to maximize the amount of people you can vaccinate, which is highly recommended. Please view the CDC webpage on the JYNNEOS vaccine for more information on administering the JYNNEOS vaccine.

Are there data reporting requirements for RWHAP recipients that receive the JYNNEOS vaccine?

RWHAP recipients that receive shipments of the JYNNEOS vaccine must submit administration and inventory/wastage data.

Health Partner Order Portal (HPOP) System

What is the HPOP system?
HPOP is a web-based tool for managing, monitoring, and reporting key metrics associated with the distribution and administration of vaccines, therapeutics, and diagnostics. The U.S. Department of Health and Human Services developed HPOP to support the mission to order and distribute effective vaccines, therapeutics, and diagnostics on accelerated timelines.
If we already have an HPOP account for the COVID-19 vaccines, do we need to request a separate account for the mpox vaccine?
No, you do not need to request a separate HPOP account for the mpox vaccine. You will need to submit information to HRSA to confirm the information associated with your organization’s HPOP account.

Use of RWHAP Funds for Mpox

Can HRSA RWHAP funds be used to support mpox testing?

Mpox testing is available through public health and commercial laboratories. Testing done through public health laboratories is free of charge, while there are costs associated with testing at commercial laboratories. If a provider caring for a RWHAP client does not have ready access to public health laboratory testing, RWHAP funds can be used to cover co-pays and deductibles for insured clients and the cost of testing for uninsured clients when a commercial laboratory is used for testing.

For more information, view the August 8, 2022 Program Letter on Mpox Guidance for RWHAP Recipients (PDF - 114 KB).

How can RWHAP recipients access mpox treatment?

CDC-recommended post-exposure prophylaxis and antiviral treatments are available for people exposed to mpox or diagnosed with mpox virus infection. RWHAP providers should work with their state/territorial health departments to access the orthopox antiviral TPOXX (tecovirimat) for the treatment of mpox and the mpox vaccines.

Can HRSA RWHAP funds be used to pay for fees associated with mpox vaccine administration and treatment?

Yes. RWHAP funds may be used to pay for fees associated with vaccine administration and treatment of mpox for eligible clients, such as medical visit costs, including personal protective equipment for staff, vaccination supplies, including co-pays and deductibles for insured clients, in accordance with Policy Clarification Notice #16-02 Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds (PDF - 172 KB).

For more information, view the August 8, 2022 Program Letter on Mpox Guidance for RWHAP Recipients (PDF - 114 KB).

Can RWHAP recipient staff reassigned to mpox be paid using RWHAP funds?

Under section 319(e) of the Public Health Service (PHS) Act, a Governor of a State or a tribal organization, or their designee, may request to temporarily reassign state and local public health department or agency personnel funded in whole or in part through programs authorized under the PHS Act (which includes the Ryan White HIV/AIDS Program) for purposes of immediately addressing a public health emergency in the State or Indian tribe during the period of the public health emergency. Section 319(e) of the PHS Act only allows reassignment of state, local, and tribal employees whose salaries are funded in whole or in part by PHS Act programs (and would not, for example, allow reassignment of staff at a private hospital-based clinic funded under Part C). Detailed information, including Guidance for Temporary Reassignment of State and Local Personnel during a Public Health Emergency, is available on the Administration for Strategic Preparedness and Response (ASPR) website. To request the temporary reassignment of personnel, a State governor, tribal organization, or their designee must complete the Request for the Temporary Reassignment of State, Tribal, and Local Personnel During a Public Health Emergency Declared by the HHS Secretary and submit it to TemporaryReassignment@hhs.gov.

Use of Health Center Program Funds for Mpox

Can HRSA Health Center Program funds be used to support mpox testing and treatment?

At this time, HRSA does not have additional funding to support HRSA-funded health centers in responding to mpox needs among their patients and other residents of their service area who may seek health center services. To the extent feasible given other primary care and COVID-19 related needs, health centers may use their existing H80 and American Rescue Plan COVID-19 grant funding to support mpox testing and treatment, vaccine administration costs for uninsured patients, as well as additional capacity necessary to address urgent and emergent needs related to the mpox virus.

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