Perspective: An overemphasis on vaccines for Mpox skewes important lessons from COVID-19 and the need for public health approaches

The emergency declarations for Mpox triggered a flurry of appeals for ‘vaccine equity’ and the mass production of additional vaccine doses, citing a need to ‘learn lessons’ from COVID-19. We question whether the right lessons have been learned in terms of a supposed need to rollout vaccines quickly and widely, raising concerns about the consequences of an overreliance on expert-driven mass vaccination strategies over more diversified, context-specific and systemic public health strategies. Compared to COVID-19, Mpox has no such epidemic potential because it requires close contact for transmission. Moreover, Congolese populations face far more pressing health burdens. Thus, the health needs of the population risk being lost within a response focused on global procurement of costly health technologies whatever the context in which the outbreak is occurring. Alternatively, locally owned prioritisation and public health and sanitation approaches are key, which should be proportionate to relative disease burdens, and which utilise a diversity of strategies that are cost-effective and with wider public health benefits.