Mpox vaccine in the Philippines: the waiting continues, but until when?

Dear Editor,

Mpox (Monkey pox) is a growing public health concern in the Philippines. The number of cases is gradually increasing in the country and will continue to rise if preventive interventions are not applied. Only nine cases were confirmed from July 2022 to December 2023, which rose to 18 cases as of August 2024. ¹ To update this, as of 2024, the country logged 911 cases. ² At the start of 2025, two cases were detected in Baguio City on January 17 and 18, respectively. Just recently, more than a dozen hit Mindanao in its three regions—Soccsksargen, Bangsamoro, and Zamboanga Peninsula. South Cotabato in the Soccsksargen region has logged the most cases, with 10 confirmed infections as of May 22. Aside from these cases, six more individuals showing symptoms are under close medical observation in isolation facilities in the Bangsamoro region. ³ In the latest Mpox Tracker in the country, as of June 2, 2025, there are 46 confirmed active cases and 38 suspected ones. ⁴

The increasing cases of mpox in the country may not be significant enough for the government to call for a public health emergency. However, it is important to note that the World Health Organization (WHO) has announced that the mpox upsurge will continue and meet the criteria of a public health emergency of international concern as outlined in the International Health Regulations. The ongoing global outbreak of clade II mpox has caused more than 100,000 cases in 122 countries, including 115 countries where mpox was not previously reported, ⁵ including the Philippines. Thus, it is always better to apply interventions to manage and control the spread of this infectious disease to prevent another health crisis in the country.

The inappropriate services of numerous massage parlors or spas are pointed out as “vehicles” for the spread of the mpox virus, especially the alleged offering of sexual services. A confirmed case in Quezon City reported that the patient had contact with a masseur in a spa. Another alarming issue is reports on these spas, whose therapists claimed they are already vaccinated against mpox to attract more clients. For example, in a social media post by a spa, featured photos of its staff wearing gloves with a hand on their chest. On the upper right corner of the art card, the words “mpox vaccinated” were indicated. This fake claim is dangerous since many spas in the Philippines are used as a “front” for prostitution, and thus can be venues for the spread of the virus. Despite the government’s effort to close some of them, these establishments’ increasing number of online set-ups continues to operate. Currently, there are 3135 massage spas in the country as of May 5, 2025, which is a 7.66% increase from 2023. These spas have established a strong digital presence across various platforms: 11 have LinkedIn profiles, 565 have Facebook Pages, 90 are active on Instagram, 47 have X (formerly Twitter) handles, 10 are on TikTok, and 33 have YouTube channels. About 1045 Massage spas have their respective websites. ⁶ The government must double its efforts to regulate these spas, especially the online set-ups.

Preventive interventions must be done to address the issue. I proposed a countrywide information campaign, vaccination for those at high risk when there is already an available vaccine, and an efficient contact tracing system. Unfortunately, until now, the Food and Drug Administration (FDA) has not approved any vaccine for MPX in the country. The country waited for the 2500 MPX vaccine doses expected to be delivered in 2023, but the waiting continues until now, after 2 years. Sadly, the country is not on the WHO’s priority list since there has been no outbreak yet. In the absence of vaccines, the government must look into the possibility of the use of three drugs that are approved treatments for mpox by the US Food and Drug Administration: Investigational New Drug—tecovirimat, cidofovir, and brincidofovir. ⁷ Tecovirimat, especially within the first week of mpox symptom onset, significantly improves symptom resolution, reduces the severity of the disease, and decreases the likelihood of hospitalization and complications in observational studies. ⁸ Similarly, the high antiviral activity of cidofovir and brincidofovir against historical and currently circulating mpox strains supports their therapeutic potential for clinical application. ⁹

Lastly, public cooperation is a must to prevent the spread of the virus. The safety protocols include isolation at home or hospital for those with mpox; washing hands often with soap and water, especially before or after touching sores; wearing a mask and covering lesions when around other people until your rash heals; keeping skin dry and uncovered; avoiding touching items in shared spaces and disinfecting shared spaces frequently; using saltwater rinses for sores in the mouth; and taking warm baths with baking soda for body sores. ¹⁰ In any health crisis, public cooperation is expected so that government interventions can be smoothly and effectively implemented.