Belgian mpox vaccination strategy (revision 2026)

Mpox virus continues to circulate, and the recent emergence of clade Ib with autochthonous transmission in several European countries has led the Superior Health Council to update Belgium’s national mpox vaccination recommendations.

Vaccination against mpox is recommended for groups at highest risk of exposure.

• Pre-Exposure Prophylaxis (PrEP): for people with frequently changing sexual partners (including MSM, transgender persons and sex workers), as well as for individuals travelling (whether for professional or personal reasons) with well defined high risk exposure scenarios.
• Post-Exposure Prophylaxis (PEP): for close contacts of confirmed, probable or suspected mpox cases, as well as specific vulnerable groups (immunocompromised persons, pregnant individuals, and children).

The recommended vaccine remains the third‑generation MVA‑BN (Imvanex®/Imvamune®/Jynneos®), a non‑replicating vaccine with a favourable safety profile.

Vaccination consists of two doses, preferably administered subcutaneously (0.5 mL with a minimum interval of 28 days between the 2 injections). Intradermal fractional dosing (0.1 mL) may be used only in case of supply constraints and in immunocompetent individuals. For post‑exposure prophylaxis, vaccination is recommended ideally within 4 days after exposure.

This version replaces advisory report no. 9727 of September 2022.