Mpox Information for Health Professionals

Mpox is a Disease of Public Health Significance (DOPHS) as “Smallpox and other Orthopoxviruses including Mpox” by the Ministry of Health under the Health Protection and Promotion Act (HPPA).

Health care providers have a duty to report DOPHS and/or communicable diseases and should also report any suspected mpox cases directly to York Region Public Health.

Contact York Region Public Health

For questions, issues or reports of any DOPHS, contact York Region Public Health’s Control of Infectious Disease team:

• Email: @email
• Telephone: 1-877-464-9675 ext. 73588 (Monday to Friday, 8:30 a.m. to 4:30 p.m.)
• On-call Response Telephone: 905-953-6478 (after 4:30 p.m. and 24/7 on weekends and holidays)
• Fax number: 905-898-5213

For more information, go the Diseases of Public Health Significance Reporting Form

Please refer to Public Health Ontario’s Infection Prevention and Control (IPAC) Recommendations for Mpox in Health Care Settings.

Approval for mpox testing is not required and any health care provider can test patients in their office. Individuals with compatible symptoms and mpox is suspected should be tested. Individuals tested for mpox should be advised to isolate at home until their results are reported and Public Health contacts them.

Please refer to Public Health Ontario’s (PHO) Mpox Virus test information page for the most up-to-date information and details on which samples to take, how to label them, and how to submit samples from a patient being investigated for mpox.

Additional questions regarding testing may be directed to PHO Laboratory Customer Service Centre at 416-235-6556/1-877-604-4567 during business hours, or after-hours 416-605-3113.

Post-Exposure Vaccination

The provision of Imvamune® for post-exposure vaccination requires a risk assessment by York Region Public Health. It is offered to contacts who may have had a high or intermediate risk exposure to a mpox case.

Individuals who have been a confirmed case of mpox or are symptomatic are NOT recommended to receive the mpoxvaccine at this time.

Ministry of Health case and contact guidance is available at Recommendations for the management of cases and contacts of mpox in Ontario.

Pre-exposure Vaccination

York Region Public Health offers two doses of Imvamune® (with at least 28 days between the first and second dose) for individuals meeting the provincial eligibility criteria for pre-exposure vaccination.

Your eligible patients can book an appointment at an upcoming clinic by visiting york.ca/mpox or calling the York Region Sexual Health Clinics at 1-800-361-5653. The webpage also provides information for the public on signs and symptoms and how to prevent mpox infection.

For detailed information on Imvamune® including the use in special populations, please see the Ministry of Health's Interim guidance on the use of Imvamune® in the context of a routine immunization program.

Are individuals eligible to get a mpox vaccine if travelling soon?  

Imvamune® vaccine is not a routine travel immunization. Individuals may get vaccinated if they meet the eligibility criteria.

Can individuals with a history of previous smallpox vaccine get vaccinated?

Yes. Individuals eligible for Imvamune® as a pre-or post-exposure vaccination and who have previously received smallpox vaccination are still recommended to receive a two-dose series of Imvamune®.  

Can individuals with a previous mpox infection get vaccinated?

No. Individuals who have been a confirmed case of mpox are NOT recommended to receive the mpox vaccine.

Who requires a medical note to receive Imvamune®?

Given the scarcity of data on the effectiveness of vaccine in certain special populations, as well as the need for clinical assessment, we are asking that the following groups speak with their health care provider and provide a medical note (or for those under the first bullet, proof of prescription) to be immunized in our clinics.  These include:

• Individuals that are immunocompromised and have a household or sexual partner that is in a pre-exposure vaccination eligible group can receive the vaccine with proof of their condition or medication (e.g., a note from their provider, a copy of their prescription or their eligible medication bottle)
• Individuals who are severely immunocompromised
• Individuals that are pregnant
• Individuals that are less than 18 years of age

Can Imvamune® be co-administered with other vaccines?

Yes, Imvamune® can be given concurrently (i.e., same day) or at any time before or after other live or non-live vaccines.

How can I promote this vaccine in my clinic(s)?

Your eligible patients can book an appointment or find locations and walk-in times for upcoming York Region Public Health clinics by visiting york.ca/mpox or calling York Region at 1-877-464-9675. You may also print and post in your clinic(s) the general vaccine clinic flyer.

In Canada, Tecovirimat (TPoxx®) is authorized by Health Canada for the treatment of human smallpox disease in adults and pediatric patients weighing at least 13 kg. The drug does not have an approved indication for the treatment of mpox in Canada. However, a licensed healthcare professional may use their clinical judgment to prescribe TPoxx® off-label for the treatment for severe mpox infections.

Detailed information on the use of TPoxx®, including eligibility criteria, is available in the Ministry of Health’s Mpox Antiviral Guidance for Health Care Providers.

Clinicians can request products by contacting the Ministry of Health Emergency Operations Centre at @email or by calling the Healthcare Provider Hotline at 1-866-212-2272.

General information on TPoxx® for patients is available in the Ministry of Health’s TPoxx® Information Sheet.