Mpox exposes fundamental obstacles for vaccinating children in outbreaks

Children could not be included in mpox vaccination roll-out within the first 100 days of the latest Mpox outbreak in the Democratic Republic of Congo and are yet to be rolled out in many countries with rising cases, despite this age group accounting for a large proportion of suspected cases and deaths.

Mpox has highlighted major ongoing structural barriers for inclusion of children in outbreak and pandemic response efforts.

These barriers include lack of early inclusion of children and pregnant women in clinical trials, including safety and efficacy studies of vaccines and an underutilisation of emergency regulatory pathways due to legal and financial considerations related to liability and indemnification arising from ‘off-label’ use of novel medical products.

WHO-coordinated response mechanisms and international pandemic response coalitions must do more to address these specific obstacles to ensure that children and population groups most at risk are protected during outbreaks.