Abstract
Dear Editor,
The mpox outbreak in 2022, which prompted the World Health Organization (WHO) to declare it a Public Health Emergency of International Concern (PHEIC) on 23 July 2022, has reshaped global health priorities and underscored the pressing need for equitable vaccine development and distribution. In the recent article “Current advances and challenges in mpox vaccine development: a global landscape,” the authors effectively present a timely review of ongoing vaccine innovations and underscore the cross-protection provided by existing smallpox vaccines, alongside the urgency of developing new immunization strategies for emerging mpox strains. 1 Their call for global surveillance, timely access, and equitable vaccine distribution resonates deeply within the public health discourse, particularly for countries such as the Philippines that remain at the margins of global vaccine access.
The authors’ emphasis on lessons learned from the COVID-19 pandemic is both relevant and necessary, especially as mpox continues to challenge national health systems. As noted in the review, vaccine disparity persists, especially in low- and middle-income countries. This disparity is particularly concerning in the Philippine setting, where, despite the WHO’s continued high-alert level for mpox, the country still has no legal access to mpox vaccines. As of 2024, the Department of Health (DOH) clarified that no mpox vaccine has been cleared for public use by the Food and Drug Administration (FDA), 2 thereby leaving a gap in protection for high-risk populations.
Critically, while the reviewed article provides an excellent synthesis of global vaccine advances, it falls short in addressing the barriers faced by countries without regulatory access, manufacturing capacity, or bilateral vaccine procurement agreements. The Philippine case illustrates the downstream implications of this oversight. Despite reporting 27 confirmed cases in 2022 with no fatalities, 2 and a staggering increase to 911 cumulative cases as of mid-2025, 3 the country’s response is constrained by a lack of vaccine access and misinformation stemming from unregulated channels. Public warnings from the DOH against the use of unauthorized vaccines further highlight the urgency for national and international coordination.4,5
Given mpox’s mode of transmission and its capacity to affect vulnerable populations—such as immunocompromised individuals, men who have sex with men, and frontline health workers—the absence of a legally approved vaccine leaves the Philippines exposed to potential clusters and future surges. Moreover, with symptoms such as painful rash, fever, lymphadenopathy, and fatigue, mpox not only causes significant morbidity but also threatens already stretched healthcare resources.
To this end, we strongly advocate for the inclusion of low- and middle-income countries, such as the Philippines, in global vaccine access frameworks for mpox, similar to the COVAX model. The development of regionally responsive policies must be coupled with public education, surveillance strengthening, and regulatory readiness. Without these, scientific progress in vaccine development will remain inequitably distributed and fail to fulfill its preventive promise.
Ultimately, this correspondence echoes the central call of the original article—action must be swift, inclusive, and just. For the Philippines and other similarly situated nations, this is not merely a health imperative but a matter of global solidarity and equitable public health protection.
