AUTHOR=Yuan Pei , Tan Yi , Yang Liu , Aruffo Elena , Ogden Nicholas H. , Bélair Jacques , Arino Julien , Heffernan Jane , Watmough James , Carabin Hélène , Zhu Huaiping 

TITLE=Modeling vaccination and control strategies for outbreaks of monkeypox at gatherings

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.1026489

DOI=10.3389/fpubh.2022.1026489

ISSN=2296-2565

ABSTRACT=Background: The monkeypox outbreak in non-endemic’s countries in recent months has led the World health Organization (WHO) to declare a Public Health Emergency of International Concern. It is thought that festivals, parties and other gatherings may have contributed to the outbreak.
Methods: We considered a hypothetical metropolitan city and modelled the transmission of monkeypox virus in humans in a high-risk group (HRG) and a low-risk group (LRG) using a Susceptible-Exposed-Infectious-Recovered (SEIR) model and incorporated gathering events. Model simulations assessed how the vaccination strategies combined with other public health measures can contribute to mitigating or halting outbreaks from mass gathering events. 
Results: The risk of a monkeypox outbreak was high when mass gathering events occurred in the absence of public health control measures. However, the outbreaks were controlled by isolating cases and vaccinating their close contacts. Also, contact tracing, vaccinating and isolating the close contacts, if it can implemented, was more effective for containment of monkeypox transmission during summer gatherings than a broad vaccination campaign among HRG, when accounting for the low vaccination coverage in the overall population, and the time needed for development of the immune responses. Reducing the number of attendees and effective contacts during the gathering could also prevent a burgeoning outbreak, as could restricting attendance through vaccination requirements.
Conclusion: Monkeypox outbreaks following mass gatherings can be made less likely with some restrictions of either the number and density of attendees in the gathering, or vaccination requirements. The ring vaccination strategy inoculating close contacts of confirmed cases may not be enough to prevent potential outbreaks, however, mass gatherings can be rendered less risky if that strategy is combined with public health measures, including identifying and isolating cases and contact tracing. Compliance of the community and promotion of awareness are also indispensable to containing the outbreak.