{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:56:48Z","timestamp":1787021808527,"version":"build-2736575974"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001459","name":"Ministry of Education - Singapore","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001459","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001459","name":"Ministry of Education - Singapore","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001459","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001350","name":"Singapore Ministry of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001350","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001350","name":"Singapore Ministry of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001350","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002241","name":"Japan Science and Technology Agency","doi-asserted-by":"publisher","award":["JPMJPR22R3"],"award-info":[{"award-number":["JPMJPR22R3"]}],"id":[{"id":"10.13039\/501100002241","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP223fa627004"],"award-info":[{"award-number":["JP223fa627004"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP22K17329"],"award-info":[{"award-number":["JP22K17329"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004460","name":"Rotary Foundation","doi-asserted-by":"publisher","award":["GG2350294"],"award-info":[{"award-number":["GG2350294"]}],"id":[{"id":"10.13039\/100004460","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001700","name":"Japanese Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"crossref"}]},{"name":"JSPS KAKENHI Grant-in-Aid","award":["JP24KJ1827"],"award-info":[{"award-number":["JP24KJ1827"]}]},{"DOI":"10.13039\/501100001352","name":"National University of Singapore","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001352","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001475","name":"Nanyang Technological University","doi-asserted-by":"publisher","award":["INCF-2023-007"],"award-info":[{"award-number":["INCF-2023-007"]}],"id":[{"id":"10.13039\/501100001475","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosmedicine.org"],"crossmark-restriction":false},"short-container-title":["PLoS Med"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Limited mpox vaccination coverage, declining cross-protection from historical smallpox vaccination campaigns, and persistent zoonotic reservoirs leave many sub-Saharan countries susceptible to mpox outbreaks. With millions of vaccine doses made available to the region since late 2024 and the absence of country-specific guidelines for allocation, estimating the country-specific impact of one-time mass vaccination strategies is necessary for ongoing outbreaks and other countries at future risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and findings<\/jats:title>\n                    <jats:p>We adapted a next generation matrix model to project disease transmission potential for 47 sub-Saharan countries from 2025 to 2050 under four transmission scenarios with different contributions of community versus sexual contacts. The model was informed by mpox datasets from Clade Ia and Ib outbreaks in the Democratic Republic of Congo (DRC), and incorporated country-specific demographics, contact patterns, and historical smallpox vaccination coverage. We then assessed strategies to reduce disease transmissibility by calculating country-specific minimum vaccine coverages and evaluating one-time, age-specific mass vaccination campaigns. At least 20 of the 47 countries are estimated to require vaccination in 2025, and 36 in 2050, to guard against potentially forthcoming national outbreaks. For 11 Clade I-affected countries, the minimum required coverage is estimated to range from 0%\u20134.8% to 14.5%\u201319.5% in 2025 with increasing sexual transmission, rising to 0%\u201310.8% and 22.6%\u201326.0% in 2050, respectively. The prioritised age group for vaccination shifts from 0\u20134 years to 20\u201329 years with additional sexual transmission. Note that all the projections were based on the best available evidence of Clade I transmission in the DRC as of December 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>With diminishing smallpox-vaccination-induced immunity, increasing disease transmissibility and potential for persistent outbreaks are expected for mpox, necessitating growing vaccine demand for outbreak containment. Given probable supply constraints, our findings could guide the ongoing and future mass vaccination efforts in sub-Saharan Africa by emphasising the prioritisation of high-risk groups, where allocation strategies are tailored to the evolving epidemiological landscape of each country.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pmed.1004726","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T17:41:11Z","timestamp":1757094071000},"page":"e1004726","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmed.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Vaccination strategies to achieve outbreak control for MPXV Clade I with a one-time mass campaign in sub-Saharan Africa: A scenario-based modelling study"],"prefix":"10.1371","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0079-7390","authenticated-orcid":true,"given":"Shihui","family":"Jin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8838-785X","authenticated-orcid":true,"given":"Toshiaki R.","family":"Asakura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7219-5981","authenticated-orcid":true,"given":"Hiroaki","family":"Murayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Niyukuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6594-8132","authenticated-orcid":true,"given":"Diafuka","family":"Saila-Ngita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2245-0331","authenticated-orcid":true,"given":"Jue Tao","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6377-7296","authenticated-orcid":true,"given":"Akira","family":"Endo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1592-1745","authenticated-orcid":true,"given":"Borame L.","family":"Dickens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"pmed.1004726.ref001","doi-asserted-by":"crossref","first-page":"101487","DOI":"10.1016\/j.nmni.2024.101487","article-title":"The resurgence of monkeypox: epidemiology, clinical features, and public health implications in the post-smallpox eradication era","volume":"62","author":"P Singh","year":"2024","journal-title":"New Microbes New Infect"},{"key":"pmed.1004726.ref002","doi-asserted-by":"crossref","first-page":"107159","DOI":"10.1016\/j.ijid.2024.107159","article-title":"The 2023\u20132024 multi-source mpox outbreaks of Clade I MPXV in sub-Saharan Africa: alarm bell for Africa and the world","volume":"146","author":"M Cevik","year":"2024","journal-title":"Int J Infect Dis"},{"key":"pmed.1004726.ref003","unstructured":"WHO. 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