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. 2023 May 26;72(21):568–573. doi: 10.15585/mmwr.mm7221a1

TABLE. Jurisdiction-specific estimates of immunity and inferred* risk and size of mpox recurrence — United States, 2023.

Jurisdiction Estimated immunity level, % Inferred* risk for recurrence, % Inferred* cumulative Monkeypox virus infections vs. 2022§ Jurisdictional immunity grouping MSM at increased risk for Monkeypox virus exposure**
Duval County, Florida
6
57
4.08
Low
12,425
Shelby County, Tennessee
10
55
3.77
Low
10,626
Hamilton County, Ohio
10
55
3.79
Low
9,970
Bexar County, Texas
11
54
3.67
Low
17,916
Dallas County, Texas
12
53
3.62
Low
45,264
Tarrant County, Texas
15
51
3.32
Low
15,909
Palm Beach County, Florida
15
52
3.36
Low
12,824
Hillsborough County, Florida
15
52
3.39
Low
17,802
Wayne County, Michigan
16
51
3.29
Low
14,705
Harris County, Texas
17
50
3.16
Low
60,769
San Bernardino County, California
18
49
3.07
Low
15,829
East Baton Rouge Parish, Louisiana
18
50
3.14
Low
3,735
Baltimore City, Maryland
19
49
3.04
Low
10,800
Pinellas County, Florida
20
48
2.96
Low
13,430
Gwinnett County, Georgia
21
48
2.89
Low
5,672
Marion County, Indiana
24
46
2.60
Low
12,681
Fulton County, Georgia
25
45
2.58
Low
27,831
Prince George's County, Maryland
26
44
2.03
Medium
9,007
Orange County, Florida
26
45
2.09
Medium
21,838
Dekalb County, Georgia
26
45
2.12
Medium
14,053
Cuyahoga County, Ohio
27
44
1.90
Medium
11,470
Cobb County, Georgia
27
44
1.96
Medium
5,980
Essex County, New Jersey
29
43
1.66
Medium
7,806
Franklin County, Ohio
31
42
1.41
Medium
15,752
Travis County, Texas
32
41
1.30
Medium
16,218
San Juan Municipio, Puerto Rico
32
41
1.30
Medium
3,773
Maricopa County, Arizona
32
41
1.33
Medium
33,513
Mecklenburg County, North Carolina
33
40
1.18
Medium
12,947
Montgomery County, Maryland
34
40
1.10
Medium
7,515
Clark County, Nevada
36
39
0.97
Medium
20,231
Bronx County, New York
36
39
0.98
Medium
19,723
Hudson County, New Jersey
37
38
0.86
Medium
8,009
Miami-Dade County, Florida
40
36
0.72
Medium
40,489
Orange County, California
45
33
0.48
Medium
17,090
Philadelphia County, Pennsylvania
47
32
0.42
Medium
18,771
Sacramento County, California
52
28
0.20
High
9,723
San Diego County, California
54
27
0.19
High
27,536
Riverside County, California
58
25
0.18
High
21,314
Broward County, Florida
59
24
0.18
High
33,886
Orleans Parish, Louisiana
61
23
0.18
High
8,057
Cook County, Illinois
63
22
0.17
High
60,444
Los Angeles County, California
63
22
0.17
High
117,361
Suffolk County, Massachusetts
64
21
0.17
High
10,356
King County, Washington
65
20
0.16
High
24,308
Alameda County, California
75
14
0.14
High
14,167
Queens County, New York
78
12
0.13
High
20,057
District of Columbia
98
<1
0.08
High
22,348
Kings County, New York
99
<1
0.07
High
30,540
New York County, New York
100
<1
0.07
High
37,900
San Francisco County, California 100 <1 0.07 High 23,577

Abbreviations: mpox = monkeypox; MSM = gay, bisexual, and other men who have sex with men.

* Risk and size of potential recurrence inferred from each jurisdiction's estimated immunity level based on primary simulated results.

At each level of immunity, 29%, 67%, and 4% of MSM with some immunity are assumed to have 1-dose, 2-dose, or infection-acquired immunity, conveying 37%, 67%, and 100% protection, respectively.

§ Median cumulative infections from simulations, relative to the size of the CDC-modeled 2022 mpox outbreak in the absence of additional vaccination or behavioral adaptation.

Grouping based on thresholds identified in primary analysis. Threshold values are as follows: high >50%, medium = 25%–50%, and low <25%.

** Estimated as the number of MSM aged ≥16 years who were recommended to receive HIV preexposure prophylaxis and the number of MSM aged ≥13 years living with HIV in each jurisdiction, using publicly available data. The estimated population was then increased by 25% for each jurisdiction to account for additional persons eligible for vaccination (e.g., MSM with lower levels of sexual activity than their already-eligible partners).