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EDMUND G. BROWN JR.
Governor

State of Californiaā€”Health and Human Services Agency
California Department of Public Health


October 10, 2022


TO:
Local Health Jurisdictions

SUBJECT:
Mpox Vaccine Allocated to Local Health Jurisdictions in California 


ā€‹Related Materials: Mpox Vaccination Information | Mpox Q&A | Mpox Landing Page

Updates as of October 10, 2022

  • Update to include strategy for Phase 4b.2 (early October)

Summary 

Of the total mpox vaccines provided to California by the federal government, to date the California Department of Public Health (CDPH) has allocated most of the doses to local health jurisdictions (LHJs) based on formulas described below. LHJs can now order vaccine supplies as needed.   

Formulas that have been used for Allocating Doses That LHJs Can Order, to Protect the Greatest Number of People at Risk

The below represents the formulas that have been used to allocate the limited number of mpox vaccines to LHJs. To estimate populations at highest risk of mpox transmission, the formulas include the number of early syphilis cases among men as a proxy.

Formula for Phase 0 (end of June)

  • A base of 6 doses was allocated to each LHJ with

    • At least 1 mpox case as of 6/27/2022, and/or

    • More than 400 early syphilis cases among men in 2019

  • Additional doses were allocated to LHJs based on their share of

    • Mpox cases (50% weight), and

    • Cases of early syphilis among men (50% weight)

  • Number of LHJs meeting criteria and allocated doses: 9

Formula for Phase 1 (early July)

  • Similar to Phase 0, using proportion of early syphilis cases among men and mpox cases weighted equally.

  • Additional vaccines were allocated to LHJs that had venues or events with large exposures that had already happened or were likely to happen in the coming weeks

  • LHJs with populations >100,000 that had not yet reported a mpox case were allocated 20 doses each for possible exposed contacts of cases.

  • Unused Phase 0 allocations were rolled into Phase 1 allocations.

Number of LHJs meeting criteria and allocated doses: 35

Formula for Phase 2a (mid-July)

  • Similar to Phase 0 and 1, using proportion of early syphilis cases among men and mpox cases weighted equally.

  • To prioritize vaccine to the highest risk areas, the limited doses were allocated to jurisdictions with cases; LHJs without cases were not allocated vaccine.

Number of LHJs meeting criteria and allocated doses: 16

Formula for Phase 2b (late July)

LHJs were eligible for Phase 2b allocation if the three criteria below were met:

  • The LHJ has had at least one mpox case reported

  • The LHJ has ordered at least 95% of their allocated vaccine doses between Phase 0-Phase 2a

  • The LHJ submitted a plan to CDPH detailing how doses would be administered to priority populations

           LHJs deemed eligible were then allocated doses using the following formula:

  • 75% based on mpox cases in the past two weeks (7/12/22-7/25/22)

  • 25% based on early syphilis cases among men

Number of LHJs meeting criteria and allocated doses: 23

Formula for Phase 3a (early August)

The formula for Phase 3a was the same as the formula for Phase 2b.

Formula for Phase 3bc (mid-August) 

The formula for Phase 3bc was the same as the formula for Phases 2b and 3a. 


Formula for Phase 4a (late August)ā€Æ 

LHJs were eligible for Phase 4a allocation if the three criteria below were met:ā€Æ 

  • The LHJ has had at least one mpox case reportedā€Æ 

  • The LHJ has ordered their Phase 3bc allocated vaccine vials 

  • The LHJ has reported ā‰„85% of doses administered out of total vials received up to Phase 3a 

            LHJs deemed eligible were then allocated doses using the following formula:ā€Æ 

  • 75% based on mpox cases in the past two weeks (8/9/22-8/22/22)ā€Æ 

  • 25% based on early syphilis cases among menā€Æ 

Formula for Phase 4b (mid September)ā€Æ 

LHJs were eligible for Phase 4b allocation if the three criteria below were met:ā€Æ 

  • The LHJ has had at least one mpox case reportedā€Æ 

  • The LHJ has self-attested to having administered ā‰„85% of doses out of total vials received up by the LHD as of 10 days prior to the date calculation is made 

LHJs deemed eligible were then allocated doses using the following formula:ā€Æ 

  • 75% based on mpox cases in the past two weeks (8/30/22-9/12/22)ā€Æ 

  • 25% based on early syphilis cases among men 

Formula for Phase 4b.2 (early October) 

 As the supply of mpox vaccine in California is currently meeting demand, CDPH will discontinue vaccine allocations for now and allow LHJs to order vaccines as needed. Each LHJ was provided with a baseline inventory of 20 vials. LHJs with mpox cases were provided additional vaccines above the baseline based on the following formula:

  • 75% based on mpox cases in the past two weeks (9/20/22-10/3/22) 
  • 25% based on early syphilis cases among men 

Future Phases 

Additional vaccine (Phase 4c tranche) is available from the federal government. CDPH will continue to order more vaccines as needed, to meet California's needs. CDPH will also continue to assess the status of the mpox outbreak and vaccine distributions to ensure at risk populations are protected. 

Federal Distribution:

For more information on Federal JYNNEOS Mpox vaccine distribution, visit the U.S. Department of Health & Human Services website. 


ā€‹ā€‹Originally published on July 22, 2022



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