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PHRP : Osong Public Health and Research Perspectives

OPEN ACCESS. pISSN: 2210-9099. eISSN: 2233-6052

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"Mpox"

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"Mpox"

Review Article

Rethinking mpox: epidemiology, clinical variants, diagnosis, and response
Renu Thakur, Devendra Pratap Singh Rajput, Nikunj Rajkumar Agrawal, Abhimanyu Agrawal
Received September 28, 2025  Accepted April 22, 2026  Published online May 27, 2026  
DOI: https://doi.org/10.24171/j.phrp.2025.0402    [Epub ahead of print]
Monkeypox disease, now commonly referred to as mpox, was once considered a geographically restricted zoonotic disease but has emerged as a global public health concern. The 2022 multinational outbreak marked a turning point, with notable shifts in transmission dynamics, affected populations, and clinical manifestations. Classical cases typically involve fever, lymphadenopathy, and a centrifugal vesiculopustular rash; however, recent outbreaks have revealed atypical presentations, including genital and perianal lesions, minimal or absent prodromal symptoms, and asynchronous rash evolution. These variations have complicated early clinical recognition and may contribute to delayed diagnosis and onward transmission. This review synthesizes current evidence on the evolving epidemiology of mpox, highlights differences between endemic and non-endemic outbreaks, and describes the full spectrum of typical and atypical clinical features. It also assesses diagnostic approaches, including molecular and point-of-care techniques, and evaluates the efficacy and limitations of current and emerging vaccines, such as JYNNEOS and ACAM2000. Future priorities include improving global surveillance, refining case definitions, expanding diagnostic access, and ensuring equitable vaccine distribution. Understanding the expanding clinical and epidemiological profile of mpox is essential for timely diagnosis, containment, and preparedness against future outbreaks.
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Brief Report
JYNNEOS vaccine safety monitoring in the Republic of Korea, 2022: a cross-sectional study
Jaeeun Lee, Seunghyun Lewis Kwon, Jinhee Park, Hyuna Bae, Hyerim Lee, Geun-Yong Kwon
Osong Public Health Res Perspect 2023;14(5):433-438.
Published online October 18, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0182
JYNNEOS vaccine safety monitoring in the Republic of Korea, 2022: a cross-sectional study
Objectives
With the recent global mpox outbreak, the JYNNEOS vaccine (Modified Vaccinia Ankara-Bavarian Nordic) was developed as a third-generation smallpox vaccine and initially favored for mpox immunization. Vaccine-associated side effects contribute to vaccine hesitancy. Consequently, tracking adverse events post-immunization is crucial for safety management. This study used data from the national active vaccine safety surveillance conducted in Korea from August 25 to November 24, 2022 to detect potential safety signals and adverse events. Methods: Data on health conditions following vaccination were gathered from web-based surveys and reported via active surveillance through the Immunization Registry Information System. This follow-up system functioned via a text message link, surveying adverse events and health conditions beginning on the second day post-vaccination. Information about specific adverse events, including both local and systemic reactions, was collected. Results: The study included 86 healthcare workers who had received at least 1 dose of the JYNNEOS vaccine. Among the respondents, 79.1% reported experiencing at least 1 adverse event, with the majority being local reactions at the injection site. The incidence of adverse events was higher following the first dose (67.9%) than after the second dose (34.4%). The most frequently reported adverse event for both doses was mild pain at the injection site. Conclusion: The study provides crucial information on the safety of the JYNNEOS vaccine, demonstrating that most adverse events were manageable and predominantly localized to the injection site. Nonetheless, additional research is needed on the safety of various vaccine administration techniques and the vaccine’s effects on broader demographics.

Citations

Citations to this article as recorded by  Crossref logo
  • Enhanced Immunogenicity and Affinity with A35R-Fc-Based Chimeric Protein Compared to MPXV A35R Protein
    Shimeng Bai, Yanxin Cui, Qibin Liao, Hongyang Yi, Zhonghui Liao, Gengwei Zhang, Fenfang Wu, Hongzhou Lu
    Viruses.2025; 17(1): 116.     CrossRef
  • The Role of Adverse Event Follow-Up in Advancing the Knowledge of Medicines and Vaccines Safety: A Scoping Review
    Vijay Kara, Florence Van Hunsel, Andrew Bate, Eugène van Puijenbroek
    Drug Safety.2025; 48(9): 977.     CrossRef
  • Potential of MRNA vaccines for mpox prevention: current evidence and future directions
    Toufik Abdul-Rahman, Ogungbemi Evelyn Faith, Oyinbolaji Akinwande Ajetunmobi, Hala Ibrahim Thaalibi, Chinelo Geraldine Ikele, Gargi Gautam, Faith Olanrewaju Omotayo, Poulami Roy, Alhazan Amir Adebayo, Muslimat Abolore Mojeed, Tolulope Taiwo Kareem, Halima
    Annals of Medicine & Surgery.2025; 87(9): 5650.     CrossRef
  • Adverse Reactions After Intradermal Vaccination With JYNNEOS for Mpox in Korea
    So Yun Lim, Yu Mi Jung, Yeonjae Kim, Gayeon Kim, Jaehyun Jeon, BumSik Chin, Min-Kyung Kim
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • First Nationwide Mpox Vaccination Program in the Republic of Korea: Implications for an Enhanced Public Health Response
    Seunghyun Lewis Kwon, Minju Song, Wonkyung Lee, Jeeyeon Shin, Su-Yeon Lee, Sang-Gu Yeo, Minjeong Kim, Sanggyun Jeong, Joonku Park, Dongwoo Lee, Sookyoung Lim
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Global perspectives on smallpox vaccine against monkeypox: a comprehensive meta-analysis and systematic review of effectiveness, protection, safety and cross-immunogenicity
    Hao Liu, Wenjing Wang, Yang Zhang, Fuchun Wang, Junyi Duan, Tao Huang, Xiaojie Huang, Tong Zhang
    Emerging Microbes & Infections.2024;[Epub]     CrossRef
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