Last updated: November 28, 2022

MPX (formerly known as monkeypox) is a rare viral illness that causes fever, headache, swollen lymph nodes and tiredness, followed by a rash on the skin. It is usually spread by very close contact with someone who has the virus.

Anyone can get MPX. However, during the current outbreak, gay, bisexual and men who have sex with men have been impacted the most. At this time, MPX has mostly spread between people who had close intimate/sexual contact with a person who has the virus. The virus also does not spread through casual contact.

MPX typically spreads from a person with the virus to others through:

  • Prolonged close contact with respiratory droplets from breathing, talking, coughing or sneezing.
  • Skin-to-skin contact with lesions, blisters, rashes.
  • Contact with objects, fabrics and surfaces used by someone who has the virus.

The virus enters the body through breaks in the skin or through the eyes and mouth.

Someone with MPX can usually pass on the virus when they develop a skin rash or blisters, but it may also spread when they have early symptoms including fever and headache.

Symptoms usually start within six to 13 days after being exposed to MPX, but can start anywhere from five to 21 days after exposure.

Symptoms include:

  • Fever
  • Headache
  • Muscle aches
  • Backache
  • Swollen lymph nodes
  • Chills
  • Feeling extremely tired
  • Cough or sore throat (sometimes)
  • Runny nose
  • Rash with blisters that can appear one to three days after fever, but in some cases, can appear before fever or other symptoms. The rash usually begins as flat red spots (that can look like pimples or heat rash), which turn into blisters and then form a crust. In some cases, the rash appears around the mouth, genital or anorectal (bum) areas.

MPX is diagnosed by a healthcare provider, based on symptoms and a laboratory test.

More Information:

  • Consider limiting the number of people you have close skin-to-skin contact with.
  • Avoid touching blisters or rashes on another person.
  • Talk to sexual partners about sexual health and use barriers such as gloves and condoms.
  • Avoid sharing objects that come into contact with another person’s body fluids such as toothbrushes, sex toys and drug use supplies.
  • Avoid prolonged close face-to-face contact with others, especially indoors.
  • Wear a mask in indoor public spaces, when possible.
  • Clean and disinfect frequently-touched surfaces (such as door handles, countertops and phones) and fabrics (such as clothing and bedding). Standard household cleaners/disinfectants/detergents can be used to kill the virus on surfaces.
  • Avoid touching bedding and laundry that has been in contact with someone who has MPX.
  • Stay home if you are sick, and encourage others to do the same.
  • Clean your hands with soap and water or use an alcohol-based hand sanitizer.
  • Get vaccinated, if eligible.

If you are caring for someone who has MPX at home:

  • Use personal protective equipment (PPE), including disposable gloves and mask.
  • Encourage the person to cover their rash and blisters (use bandages, wear a long sleeve shirt and long pants) and to wear a mask when you are close to them.
  • Avoid skin-to-skin contact, including contact with blisters.
  • Clean your hands with soap and water after each contact with the person.

If you think you have MPX, it is important to isolate right away and contact a health care provider.  For more information on how to self-isolate, visit the MPX: Self-Isolation Guidance page.

You can get tested for MPX at a healthcare provider’s office, local walk-in clinic or sexual health clinics. Call in advance to make sure that MPX testing is available. Please do not call or go to an emergency department for testing. Only go to the emergency department if you need emergency care.

The most accurate MPX test is a swab of the fluid from bumps, blisters, sores or scabs.   Throat and nose swabs, as well as a blood test are available but less accurate.  A health care provider will decide which test is recommended.

Toronto Public Health will contact and give guidance to people who test positive for MPX as well as known close contacts of someone who tests positive.

People who have been in contact with a person who has MPX should monitor themselves for symptoms for 21 days. If no symptoms appear you can continue with normal activities. If symptoms develop, you should isolate and contact a healthcare provider.

Most people recover from MPX on their own within 2 to 4 weeks. However, some people can get seriously sick. Most people do not require treatment for MPX.

The Imvamune® vaccine is approved in Canada for protection against MPX. The vaccine:

  • Requires two doses, given 28 days apart, for full protection – the second dose is a full dose exactly like the first at Toronto Public Health clinics. Eligible groups are encouraged to get two doses as soon as possible and before travel.
  • Is safe and effective.
  • Contains modified virus and cannot make you sick.
  • Teaches your immune system to recognize and fight the MPX virus.
  • Can be used before getting exposed to the virus (pre-exposure vaccination) or within 14 days after being exposed (post-exposure vaccination).
  • May be given to someone who got a smallpox vaccine in the past.
  • Is injected into the fat layer on top of the muscle in the upper arm.
  • Does not leave a scar like the older version of the smallpox vaccine.
  • Takes two weeks after vaccination to give you protection. During these two weeks, consider reducing your number of close contacts, including sex partners.

Vaccine Side Effects:

The vaccine may cause some side effects. Most are mild to moderate, and do not last longer than 7 days. Common side effects include:

  • Redness, pain or swelling at the injection site
  • Feeling tired
  • Headache
  • Muscle aches
  • Nausea

Vaccine Ingredients & Allergies:

Individuals who are allergic or hypersensitive to any vaccine ingredient should speak with a healthcare provider before getting the vaccine. Learn more about the list of vaccine ingredients.

Imvamune may contain trace amounts of antibiotics (gentamicin and ciprofloxacin) and egg products. People with known hypersensitivity to these products are still able to safely get the vaccine, but should be monitored for an extra 15 minutes (30 minutes total) after getting vaccinated.

Contact a health care provider or go to the nearest emergency department if you have any of these symptoms after getting the vaccine:

  • Hives
  • Swelling of the face or mouth
  • Trouble breathing or shortness of breath
  • Chest pain or a pounding heart

Adverse Events Following Immunization (AEFI):

An AEFI is any time you feel unwell more than what you were told to expect after getting a vaccine. If you think you are experiencing an AEFI, contact a health care provider.

Your health care provider will report the AEFI to Toronto Public Health (TPH). TPH will help the health care provider investigate if your illness was caused by the vaccine. TPH reports AEFIs to the Ontario Ministry of Health, Public Health Ontario, and the Public Health Agency of Canada to make sure that vaccines continue to be safe. Companies that make vaccines do not help investigate AEFIs.

Toronto Public Health continues to follow federal and provincial guidance on the administration of Imvamune vaccines to protect at-risk populations against the MPX virus.

Based on Ontario Ministry of Health guidelines, two vaccine doses, given at least 28 days apart, are available to eligible groups.

Eligible Groups for Pre-Exposure Vaccination:

a. Two-Spirit-, non-binary, transgender, cisgender, intersex, or gender-queer individuals who self-identify or have sexual partners who self-identify as belonging to the gay, bisexual, pansexual and other men who have sex with men (gbMSM) community AND at least one of the following:

  • Had a confirmed sexually transmitted infection (STI) within the last year ;
  • Have or are planning to have two or more sexual partners or are in a relationship where at least one of the partners may have other sexual partners;
  • Have attended venues for sexual contact (e.g. bathhouses, sex clubs) recently or may be planning to, or who work/volunteer in these settings;
  • Have had anonymous sex (e.g. using hookup apps) or may be planning to; and/or
  • Are a sexual contact of an individual who engages in sex work.

b. Individuals who self-identify as engaging in sex work or are planning to, regardless of self-identified sex or gender.

c. Research laboratory employees working directly with replicating orthopoxviruses. This completed form must be provided.

Household and/or sexual contacts of people who are eligible for Pre-Exposure Vaccination listed above in parts (a) or (b) above AND who are moderately or severely immunocompromised (have a weak immune system) or are pregnant may be at risk for severe illness from a MPX infection. These individuals may be considered for Pre-Exposure Vaccination, and should contact a healthcare provider or Toronto Public Health for more information.

Eligibility for Post-Exposure Vaccination:

  • Toronto Public Health will assess the risk of exposure of a person to see if the vaccine is recommended.
  • People who have a known exposure/close contact with someone with MPX, or an exposure in a setting where MPX is spreading, should contact Toronto Public Health to find out if the vaccine is recommended to them.
  • When the vaccine is used as Post-Exposure Vaccination, it should be given within four days, but can be given up to 14 days after the last exposure.
  • Individuals who have had one dose as post-exposure vaccination can get a second dose at least 28 days later.
    • People who are under the age of 18 should consult a healthcare provider before getting their 2nd

Contact a healthcare provider or Toronto Public Health to find out if you are eligible for vaccination. The vaccine is free and available to all eligible people. No ID or OHIP required. Appointments are needed for City-run Immunization Clinics.

Wait to get vaccinated if you have any COVID-19 symptoms and/or you are required to self-isolate.

If you think you have MPX, isolate right away and contact a health care provider. Do not visit any MPX vaccination clinics.

The vaccine is not used as a treatment if you already have MPX. At this time, people who have or have had MPX are not eligible for the vaccine because they have immunity from the infection.

Getting the vaccine at the same time as another vaccine:

Right now, we don’t have information about getting Imvamune at the same time as other vaccines. It is recommended:

  • Not to delay getting Imvamune if you were exposed to MPX or are at high risk of exposure, even if you have recently gotten another vaccine, as the benefits are bigger than the risks.
  • After getting the Imvamune vaccine, to wait at least 2 weeks before getting another non-live vaccine (e.g. COVID-19, flu or meningococcal) and 4 weeks before getting another live vaccine (e.g. Shingles or MMR).
  • To speak with a healthcare provider if you are getting Imvamune less than 4 weeks before or after another live vaccine, as this may make the second vaccine less effective.

Toronto Public Health (TPH) and community partners will be hosting the following MPX vaccination clinics for eligible groups.

City-run clinics

People who meet the provincial criteria for vaccination to prevent MPX infection can book an appointment at any one of our six City-run clinics through the TPH Booking System. Our City-run clinics are operating by appointment only for the MPX vaccine. An OHIP card is not required. The vaccine is free and available to all eligible people.

The 519

Day(s) and Hours of Operation: To be announced.

Address: 519 Church St., Toronto

The following community clinics are available by appointment only. Please call or email the clinic you wish to visit directly to book your appointment.

Safer Six

Day(s) and Hours of Operation:

  • Tuesday: 10AM-5PM
  • Wednesday: 2PM-7PM
  • Thursday: 2PM-7PM
  • Saturday: 9AM-12PM

Address: 27 Roncesvalles Avenue – Suite 505, Toronto.

To book an appointment please call: (647) 657-4033.

Visit the Safer Six website for more information.

Specialty Health Clinic

Day(s) and Hours of Operation: Mondays to Fridays, 10 a.m.- 6 p.m.

Address: 34 Wellesley Street E, first floor

To book an appointment please email Mia Biondi, NP-PHC at mia.biondi@mail.mcgill.ca.

All City-run clinics are able to offer accommodation.

Vaccine Clinic Accessibility

Each City-run clinic has parking near the entrance, ramps, elevators, and wheelchairs. Staff are also on site at each clinic to support if required. Clients who need a care provider or service animal with them will be accommodated. There are also privacy rooms available upon request. If you require an accommodation, alert a staff member upon arrival or at any time while at the clinic.

Vaccine Clinic Accommodation Request

You may request an accommodation ahead of attending a City-run clinic. You will be asked the date and time when you plan to access your vaccination dose and a public health nurse will contact you within two business days to confirm the details of your request.

Request an Accommodation

Examples of accommodations we can provide include:

  • The use of a private area in the clinic to receive the vaccine
  • Using a guide to help navigate the clinic
  • Access to a cot to lie down after you have received the vaccine
  • Access to ASL interpretation (at least 48 hours’ notice required)

If you require assistance filling out the survey or requesting accommodation, please call Toronto Public Health at 416-338-7600 (TTY: 416-392-0658).

To view the latest data on MPX in Toronto, visit Public Health Ontario’s MPX webpage.

Document Image Description Translations
Prevent the Spread of MPX Poster

Download the Prevent the Spread of MPX Poster Spanish
Preventing MPX Spread Checklist

Download the Preventing MPX Spread Checklist Poster
Reduce the Spread of MPX When Using Drugs Poster

Download the Reduce the Spread of MPX When Using Drugs Poster Spanish
MPX Self-Screening Poster

Download the Help Stop the Spread of MPX Poster
MPX Fact Sheet

Download the MPX Fact Sheet Spanish
MPX Vaccine Fact Sheet

Download the MPX Vaccine Fact Sheet Arabic | Chinese – Simplified | Korean | Somali | Spanish | Urdu | Vietnamese
MPX Stigma & Discrimination

Download the MPX Stigma & Discrimination Poster
Differences between MPX, Chickenpox, and Hand, Foot & Mouth Disease

Download the Differences between MPX, Chickenpox, and Hand, Foot & Mouth Disease Poster
Getting Accessibility Support for the MPX Vaccine

Download the Getting Accessibility Support for the MPX Vaccine Poster