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Vaccine update: issue 360, July 2025, Mpox & Men B special

Published 25 June 2025

Applies to England

Mpox and Meningococcal B vaccine for GBMSM in specialist sexual health services

Introduction of new routine mpox and 4CMenB for gonorrhoea vaccination programmes, primarily for gay, bisexual and other men who have sex with men (GBMSM) at higher risk of acquiring these infections, delivered by local authority commissioned sexual health services from 1 August 2025.

The letter published on 13 June provides the information required to implement the expanded pre-exposure mpox and new 4CMenB for gonorrhoea vaccination programmes primarily targeting GBMSM in sexual health services. There will be a rolling start from 1 August 2025, with all providers offering vaccinations by 1 September 2025.

This letter follows on from the NHS England system letter dated 21 May 2025 and is aimed at those who are responsible for commissioning and delivering vaccination programmes in sexual health services. We encourage you to share this letter and its annexes with all those involved in delivering the programmes in your area.

Key points about the programmes:

• both programmes are being commissioned by NHS England working together with Integrated Care Boards (ICB), local authorities (including directors of public health), and sexual health service providers
• eligible individuals are primarily GBMSM who are at highest risk of acquiring these infections, as well as a small number of individuals who are not GBMSM but who have a similar incidence to the eligible GBMSM. Individuals should be identified through sexual health services using markers of high risk of infection, as per the Green Book guidance
• dependent on eligibility, staff should identify opportunities where the vaccines can be co-administered or offered alongside other vaccines (such as vaccines for Hepatitis A or B or Human papillomavirus (HPV)) to maximise benefit and reduce the time the person remains unprotected and at risk. Mpox (Imvanex®) and 4CMenB (Bexsero®) vaccines can be administered with or at any interval before or after all other vaccines

The Joint Committee on Vaccination and Immunisation (JCVI)

The Joint Committee on Vaccination and Immunisation (JCVI) is an expert scientific advisory committee which advises the UK government on vaccination and immunisation matters.

Mpox

Building on the previous limited offer of pre-exposure mpox vaccination introduced during the mpox outbreak in 2022, the JCVI has since advised an ongoing routine vaccination strategy for protection against mpox to prevent future outbreaks and protect those at risk of exposure. The JCVI advised that mpox vaccination should target gay, bisexual and other men who have sex with men (GBMSM) who are at highest risk of exposure, to be identified at sexual health services.

Gonorrhoea

The JCVI considered evidence on the cost-effectiveness of a potential 4CMenB for gonorrhoea vaccination programme and its likely impact on epidemiology. The committee agreed that a targeted programme should be initiated using the 4CMenB (Bexsero®) vaccine for the prevention of gonorrhoea in those who are at greatest risk of infection. As protection against gonorrhoea isn’t currently a licensed indication for 4CMenB vaccine, which is licensed for meningococcal B disease, this advice is based on off-label use of vaccine.

It is important for individuals offered vaccination to understand that real world studies have estimated that the 4CMenB vaccine has between 32.7% to 42% effectiveness against gonorrhoea. Therefore, although vaccination would be expected to reduce the chance of becoming infected with gonorrhoea, it would not completely eliminate the possibility. The main benefit of a vaccination programme is expected to be at a community level with a significant reduction in the number of cases overall. It is expected that the vaccination programme would help tackle the increasing levels of antibiotic-resistant strains of gonorrhoea.

Service arrangements

In planning these services, commissioning partners and providers should consider how commissioning and operational delivery can be aligned with other vaccination programmes in sexual health services. All local authority commissioned sexual health service providers should be engaged in plans to consider how they could offer the programmes to ensure effective programme coverage and equity of access. There may be exceptional circumstances where the service offer is consolidated locally.

Commissioning will be through direct award process B under the Health Care Services (Provider Selection Regime) Regulations 2023. Funding for 2025/26 deployment has been communicated and distributed as part of the public health allocations to regional commissioners for 2025/26, who will confirm payment arrangements based on local agreements.

Providers should consider the most effective method of implementing the vaccination programmes, both in terms of optimisation of resources and high uptake of the vaccination offer. This will include opportunistic identification of eligible individuals attending the service for other reasons and might include use of vaccination clinic models or booking systems, for example, to facilitate appointments for second doses. Providers should also consider what strategies can be adopted to address health inequalities when implementing these vaccination programmes.

Vaccine coverage data collection

Vaccination events should be recorded on the provider’s electronic patient records management system in a timely manner. The service will be required to report vaccination codes with their routine quarterly GUMCAD STI surveillance system returns to UKHSA in the usual way of submitting GUMCAD data. Any additional reporting requirements will be agreed between the provider and the commissioner.

Immunisation Against Infectious Disease (the Green Book)

Prior to and during participation in the vaccination programmes, clinical teams must be up to date with clinical guidance and understand the latest version of the relevant Green Book chapters. The latest smallpox and mpox Green Book chapter.

Green book on immunisation – Gonorrhoea chapter

Gonorrhoea is caused by the bacterium Neisseria gonorrhoeae. It is one of the most common bacterial sexually transmitted infections (STI) in England and worldwide.

A new 4CMenB for gonorrhoea selective vaccination programme primarily targeting gay, bisexual and other men who have sex with men (GBMSM) in specialist sexual health services is being introduced. There will be a rolling start from 1 August 2025, with all providers offering vaccinations by 1 September 2025.

This chapter was published on 11 June 2025 and you can read it on GOV.UK.

Technical, epidemiological overview, monitoring and surveillance

The UK Health Security Agency (UKHSA) is monitoring the effectiveness and impact of mpox and 4CMenB vaccination for gonorrhoea in the real world.

This includes monitoring effectiveness of 2 doses of MVA-BN vaccine against mpox in in GBMSM in England is estimated to be around 70% to 80%. More information is available in the scientific papers published in the lancet and Emerging Infectious Diseases.

It also includes evaluation of impact of 4CMenB immunisation against gonorrhoea programme in England will start once the programme begins.

UKHSA also carries out disease surveillance of mpox and gonorrhoea:

• mpox clade Ib and clade IIb: epidemiological overview
• Gonorrhoea: STI quarterly surveillance reports STI quarterly surveillance reports: provisional data and STI annual data

Patient Group Directions (PGDs)

Both of the following PGDs require appropriate authorisation before use:

• Mpox vaccine PGD template
• PGD template for the use of 4CMenB vaccine Bexsero against gonorrhoea will be available from 1 July

Training materials and information for healthcare practitioners

Staff must be trained and competent to undertake activities within their scope of practice to support the vaccination programmes.

Mpox resources (training slides, information for healthcare practitioners and an e-learning session) are already available.

Vaccination against mpox

Vaccination against mpox in relation to an outbreak or incident training slide set for healthcare professionals is available for download.

Mpox routine vaccination programme for the protection of GBMSM training slide set for health professionals is available for download.

There is a video of the Intradermal technique for administering the MVA-BN vaccine to view, download and use with the training slide set.

Gonorrhoea resources (comprehensive training slides and information for healthcare practitioners) will be made available from 1 July. A very short (introductory) training session will be added to the main immunisation e-learning at a later date.

Patient facing resources

Patient information materials (for example, vaccination leaflets) are a critical part of the consent process and paper copies should be readily available to provide to patients prior to vaccination and supported by a conversation with a trained healthcare professional. Leaflets will be translated into a range of languages and accessible formats, and these will be available shortly

Mpox vaccination patient resources are available to order and download.

Protecting you from mpox: information on the vaccination for GBMSM Product code: 2024MPIEN.

Meningococcal B (MenB) vaccination against gonorrhoea poster. This poster is available to promote the vaccination and should be used in sexual health clinics and other healthcare settings.

Mpox vaccination record card Product code: MPX24RC. Record cards come in packs of 25 cards so if you order 2 packs, you will have 50 record cards in total. Record cards are available to order. Please only order to match the stock you are actually receiving.

Men B record card. This is the vaccination record card which should be completed by the health professional to show the:

• name of the vaccine
• date it was given
• date of second appointment for the final dose of Men B vaccine

Paper copies of this leaflet product code: MGB01EN, the record card, product code: GON25EN available to download and order from the Health Publications website.

Meningococcal B (MenB) vaccination against gonorrhoea guide

This leaflet includes information on:

• what gonorrhoea is and how you get it
• the vaccine
• how the vaccine works and who is eligible for vaccination
• when and how to get the vaccination

This should be given to all eligible GBMSM before their vaccination. It should also be accompanied by a record card. This is an important reminder to have the second dose of vaccine for the best protection and is available to download and order.

Meningitis B to protect against gonorrhoea for GBMSM – Bengali	MBG01BEN
Meningitis B to protect against gonorrhoea for GBMSM – Chinese (Simplified, Mandarin)	MBG01CHS
Meningitis B to protect against gonorrhoea for GBMSM – French	MBG01FR
Meningitis B to protect against gonorrhoea for GBMSM – German	MBG01DE
Meningitis B to protect against gonorrhoea for GBMSM – Italian	MBG01IT
Meningitis B to protect against gonorrhoea for GBMSM – Polish	MBG01POL
Meningitis B to protect against gonorrhoea for GBMSM – Portuguese	MBG01PT
Meningitis B to protect against gonorrhoea for GBMSM – Romanian	MBG01RO
Meningitis B to protect against gonorrhoea for GBMSM – Spanish	MBG01ES

Ordering free printed resources

All patient facing resources can be ordered free of charge via Health Publications.

All users need to register to receive deliveries. If you register as a health professional, you can order 500 to 1,000 copies on the website. For larger quantities, please call 0300 123 1002, or email dhextracopies@prolog.co.uk.

Vaccine supply

Routine vaccination programme

Meningococcal B (Men B) vaccination for protection against gonorrhoea

From summer 2025, Meningococcal B (MenB) vaccination for protection against gonorrhoea, will be offered by specialist sexual health services, to gay, bisexual, and men who have sex with men (GBMSM).

From Monday 7 July 2025, sexual health services in England will be able to order Bexsero® (Men B) vaccine via ImmForm. High-level ordering controls will be in place to reduce the risk of ordering errors only. These are not intended to restrict activity. ImmForm customers in Scotland and Wales should refer to their local ordering restrictions.

For customers that also access Bexsero® for the infant immunisation programme, when ordering Bexsero®, orders should be placed for the ImmForm product that is specific to the programme for which the stock is intended. Bexsero® ordered for the infant immunisation protection programme should not be used for the GBMSM gonorrhoea protection programme and vice versa.

Bexsero® vaccine ordered via ImmForm is supplied as a ten-dose pack, containing ten pre-filled syringes of vaccine and one patient information leaflet (PIL). Each 10 dose pack of Bexsero® vaccine ordered via ImmForm is supplied with a pad of 10 additional PILs.

The 10 dose pack of Bexsero® vaccine supplied via ImmForm does not contain needles for administration. Guidance on the choice of needle size can be found in the Green Book Chapter 4. Needles should be obtained locally.

Please add Bexsero® vaccine to your routine ImmForm order where possible, rather than creating additional orders.

To minimise wastage due to fridge failures, please order no more than 2 weeks’ worth of stock.

Details about Meningococcal B (Men B) vaccination for use against gonorrhoea can be found in the on the guidance leaflet.

Further details about Bexsero® vaccine can be found in the PIL.

Contact the helpdesk@immform.org.uk for ordering queries.