{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T19:58:22Z","timestamp":1772740702643,"version":"3.50.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"1","funder":[{"name":"US government"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>After months of few mpox cases, an increase in cases was reported in Chicago during May 2023, predominantly among fully vaccinated (FV) patients. We investigated the outbreak scope, differences between vaccinated and unvaccinated patients, and hypotheses for monkeypox virus (MPXV) infection after vaccination.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We interviewed patients and reviewed medical records to assess demographic, behavioral, and clinical characteristics; mpox vaccine status; and vaccine administration routes. We evaluated serum antibody levels after infection and compared patient viral genomes with MPXV sequences in available databases. We discussed potential vaccine compromise with partners who manufactured, handled, and administered the vaccine associated with breakthrough infections.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During 18 March\u201327 June 2023, we identified 49 mpox cases; 57% of these mpox patients were FV. FV patients received both JYNNEOS doses subcutaneously (57%), intradermally (7%), or via heterologous administration (36%). FV patients had more median sex partners (3; interquartile range [IQR] = 1\u20134) versus not fully vaccinated patients (1; IQR = 1\u20132). Thirty-six of 37 sequenced specimens belonged to lineage B.1.20 of clade IIb MPXV, which did not demonstrate any amino acid changes relative to B.1, the predominant lineage from May 2022. Vaccinated patients demonstrated expected humoral antibody responses; none were hospitalized. No vaccine storage excursions were identified. Approximately 63% of people at risk for mpox in Chicago were FV during this period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our investigation indicated that cases were likely due to frequent behaviors associated with mpox transmission, even with relatively high vaccine effectiveness and vaccine coverage. Cases after vaccination might occur in similar populations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciae181","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T10:26:58Z","timestamp":1712140018000},"page":"122-129","source":"Crossref","is-referenced-by-count":11,"title":["Investigation of an Mpox Outbreak Affecting Many Vaccinated Persons in Chicago, Illinois\u2014March 2023\u2013June 2023"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1636-7061","authenticated-orcid":false,"given":"Emily A G","family":"Faherty","sequence":"first","affiliation":[{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"},{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor","family":"Holly","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasmin P","family":"Ogale","sequence":"additional","affiliation":[{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hillary","family":"Spencer","sequence":"additional","affiliation":[{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"},{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley M","family":"Becht","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gordon","family":"Crisler","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Wasz","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Stonehouse","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah J","family":"Barbian","sequence":"additional","affiliation":[{"name":"Departments of Internal Medicine, Rush University Medical Center , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christy","family":"Zelinski","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyse","family":"Kittner","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorothy","family":"Foulkes","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kendall W","family":"Anderson","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiffany","family":"Evans","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lavinia","family":"Nicolae","sequence":"additional","affiliation":[{"name":"National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber","family":"Staton","sequence":"additional","affiliation":[{"name":"Office of the Chief Operating Officer, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Hardnett","sequence":"additional","affiliation":[{"name":"National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael B","family":"Townsend","sequence":"additional","affiliation":[{"name":"National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William C","family":"Carson","sequence":"additional","affiliation":[{"name":"National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panayampalli S","family":"Satheshkumar","sequence":"additional","affiliation":[{"name":"National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina L","family":"Hutson","sequence":"additional","affiliation":[{"name":"National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Crystal M","family":"Gigante","sequence":"additional","affiliation":[{"name":"National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura A S","family":"Quilter","sequence":"additional","affiliation":[{"name":"National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Gorman","sequence":"additional","affiliation":[{"name":"Department of Health and Human Services, Office of Strategic National Stockpile , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Borah","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie R","family":"Black","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6638-0961","authenticated-orcid":false,"given":"Massimo","family":"Pacilli","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Kern","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janna","family":"Kerins","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea M","family":"McCollum","sequence":"additional","affiliation":[{"name":"National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7231-555X","authenticated-orcid":false,"given":"Agam K","family":"Rao","sequence":"additional","affiliation":[{"name":"National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Tabidze","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,4,3]]},"reference":[{"key":"2024071918111032800_ciae181-B1","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1056\/NEJMoa2207323","article-title":"Monkeypox virus infection in humans across 16 countries\u2014April\u2013June 2022","volume":"387","author":"Thornhill","year":"2022","journal-title":"N Engl J 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and Prevention"},{"key":"2024071918111032800_ciae181-B7","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.15585\/mmwr.mm7145a4","article-title":"Epidemiologic features of the monkeypox outbreak and the public health response\u2014United States, May 17\u2013October 6, 2022","volume":"71","author":"Kava","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2024071918111032800_ciae181-B8","author":"Chicago Department of Public Health"},{"key":"2024071918111032800_ciae181-B9","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1136\/sextrans-2023-055922","article-title":"Modelling the impact of vaccination and sexual behaviour adaptations on mpox cases in the USA during the 2022 outbreak","volume":"100","author":"Clay","year":"2024","journal-title":"Sex Transm Infect"},{"key":"2024071918111032800_ciae181-B10","doi-asserted-by":"crossref","first-page":"696","DOI":"10.15585\/mmwr.mm7225a6","article-title":"Notes from the field: emergence of an Mpox cluster 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