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11th July 2022
TO:

LA(22)14

LABOUR AFFAIRS COMMITTEE
ALL MEMBERS & ASSOCIATE MEMBERSBIWEEKLY MEMBERS MEETING PARTICIPANTS
INTERNATIONAL ASSOCIATION GROUP PARTICIPANTS

COVID-19 UPDATE and MONKEYPOX UPDATE AS OF 11th July 2022
Action Required: Globally, as of 8th July 2022, there have been 551,226,298 confirmed
cases of COVID-19, including 6,345,595 deaths, reported to WHO. As of 3rd July 2022,
a total of 12,037,259,035 vaccine doses have been administered.
SITUATION IN NUMBERS BY WHO REGION

GlobalAmericasCases
551,226,298
164,535,057

Deaths6,345,595
2,767,057

EuropeSouth-East Asia
Eastern Mediterranean
AfricaWestern Pacific

231,506,184
58,742,623
22,120,374
9,143,649
65,177,647

2,030,921
790,481343,727
173,702239,694

TOP 12 COUNTRIES
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2
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5
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8
9

USA
India
BrazilFranceGermany
UK
Italy
Korea
RussiaMOST CASES YESTERDAYFranceUSA
Italy
Germany
BrazilJapan
Australia
China
MexicoHIGH FATALITIESYESTERDAY
USA
BrazilFrance
China
Italy
Chile
MexicoRussiaAustralia

Registered Office Walsingham House, 35 Seething Lane, London, EC3N 4AH
Registered in England and Wales No. 2532887

10
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TurkeySpain
Vietnam

Korea
India
GreeceIndia
GreecePortugal

COVID-19(22)14-Annex 1 - 5 July 2022_COVID testing requirements for international travel
COVID-19(22)14-Annex 2 - Weekly_Epi_Update_99
COVID-19(22)14-Annex 3 - ECDC-WHO-Risk-communication-community-engagementmonkeypox-outbreak-Europe
COVID-19(22)14-Annex 4 - ICAO Vaccination Report 5 July22
COVID-19(22)14-Annex 5 - monkeypox_euro_ecdc_draft_jointreport_2022-07-06

Ondrilla Fernandes
Employment Affairs Advisor

Reopen for International Travel Without COVID-19 Testing Required（139 Member States）
Updated on 5 July, 2022
Albania

Effective May 1, 2022, the Government of Albania repealed COVID-19-related entry requirements.(Last updated: 06/11/2022)

https://al.usembassy.gov/updates_covi
d19/

Algeria

Effective March 20, 2022, passengers can enter Algeria without restriction if they are fully vaccinated and if their last vaccine is not older
than 9 months.Non-vaccinated passengers and those whose vaccinations are older than 9 months must have a negative PCR test within
72 hours of the time of arrival.

https://dz.usembassy.gov/covid-19information/

AndorraThe Andorran authorities have taken no measures to close the borders and movement into the country. The Government of Andorra istherefore currently applying no restrictions on entering the country, nor on the movement of people and vehicles around its territory.

https://visitandorra.com/en/covid-19-inandorra/faq-if-you-re-spending-a-fewdays-in-andorra/

Arriving passengers are not required to present verifiable documentation of full vaccination to be permitted entry into Antigua andAntigua and Barbuda.Fully vaccinated arriving passengers are not required to present a PCR/Rapid Antigen Test negative result to be permitted entry
Barbuda into Antigua and Barbuda, (unless they show symptoms of possible infection). This includes transiting passengers.((Last
updated:04/16/2022)
Argentina

Travelers are not required to provide proof of a negative COVID-19 test result before traveling to Argentina.People who have an
incomplete vaccination schedule are recommended to have a diagnostic test within 24 hours of their entry into the country.

https://visitantiguabarbuda.com/traveladvisory/https://www.argentina.gob.ar/interior/mi
graciones/ddjj-migraciones

According to the amendments of the Government Decree: № 1514-N of September 11, 2020, which entered into force on May 1, 2022:
Armenia

https://www.gov.am/en/covid-travelThe passengers are NO LONGER REQUIRED to present a COVID-19 PCR test or a Certificate of complete vaccination against COVID-19 restrictions/to enter the Republic of Armenia.

Australia

Changes to the requirements for travel into and out of Australia came into effect on 18 April 2022. The Australian Government no longer
requires people travelling to Australia to have a COVID-19 test before travel.You do not need to provide proof of COVID-19 vaccination to
travel to and from Australia.

Austria

https://www.austria.info/en/service-andTravel to Austria is possible for touristic purposes.Since 16 May, proof of vaccination/recovery or a test are no longer needed.(Last update:facts/coronavirus-information/entry2022/05/17)
regulations

Azerbaijan The Cabinet of Ministers announced that, beginning April 15, 2022, the need for a negative PCR test for entry to Azerbaijan is eliminated.

https://www.health.gov.au/healthalerts/covid-19/internationaltravel/inboundhttps://az.usembassy.gov/covid-19information-for-azerbaijan/

BahamasEffective Sunday 19th June 2022 at 12:01 am The Bahamas Travel Health Visa (BTHV) will no longer be required to travel to The
Bahamas.
All unvaccinated travelers ages 2 and older will be required to obtain a negative COVID-19 test - either a negative RT-PCR or a
Rapid Antigen Test to be presented at check-in.
Vaccinated travelers will only be required to present proof of vaccination at check-in.

https://travel.gov.bs/

BahrainStarting from 20 February 2022, All passengers arriving in the Kingdom of Bahrain do not need to conduct a PCR test upon
arrival.Cancellation of the precautionary quarantine for all passengers arriving in the Kingdom of Bahrain.

https://healthalert.gov.bh/en/article/entr
y-procedures-through-kingdom-ofbahrain

1) Vaccinated with Covid-19 vaccine:Travelers completed full dose (single/double dose as applicable for a full dose) of WHO approved
Covid-19 vaccine can enter Bangladesh with the official proof of certification of vaccination and no RT PCR based COVID-19 negativecertificate is required.
Bangladesh2) Not vaccinated with Covid-19 vaccine:Travelers without having full dose (single/double dose as applicable for a full dose) of Covid-19
vaccine can enter Bangladesh if they possess RT PCR based COVID-19 negative certificate done within 72 hours of departure time
(Last update: 2022/06/02)

http://caab.gov.bd/circul/AT-CircularFSR-03-2022%20(02June22).pdf

Barbados

Effective Wednesday, May 25, 2022, fully-vaccinated travellers to Barbados will no longer have to take a COVID-19 test to enter thecountry.

https://www.visitbarbados.org/covid-19travel-guidelines-2022

Belarus

There are no restrictions on entry into Belarus for citizens of Belarus, foreign citizens and stateless persons.

https://gpk.gov.by/covid-19/

Belgium

From 23 May 2022, measures will only apply to travellers coming from a very high risk country.

https://www.infocoronavirus.be/en/travels/

BelizeEffective March 1, 2022, fully vaccinated travellers no longer require a negative test but must show proof of vaccination for entry into
Belize’s airport, land borders or sea ports.If unable to show proof or if unvaccinated, the traveller must present proof of a negative PCR
result taken within 72 hours of arrival or a negative Antigen Rapid test taken within 48 hours of arrival. A test can be administered by the
Ministry responsible for health at the airport.
Every child under the age of 5 years shall not be subjected to testing for SARSCoV2 upon entry into Belize through airport, land or sea
port.

https://belizetourismboard.org/news-andgallery/belize-covid-19-travelupdates/#1644266913182-1e31ba74-2de7

Benin

There is no negative COVID-19 test (PCR and/or serology) required for entry Benin.(Last updated: 06/16/2022)

https://bj.usembassy.gov/info-covid19/

Bolivia

Travelers to Bolivia must comply with the following requirements.(Last Updated 6/13/22)
Present a COVID-19 vaccination certificate, or
Present a negative COVID-19 RT-PCR test (for persons older than 5 years) taken no more than 72 hours prior to embarkation, or
Present a negative COVID-19 nasal antigen test (for persons older than 5 years) no more than 48 hours prior to embarkation.

https://bo.usembassy.gov/covid-19information/

Bosnia andAs of May 26, 2022, BiH authorities have removed entry restrictions related to COVID-19.
Herzegovina

https://granpol.gov.ba/Content/Read/74?title=COVID-19

Fully vaccinated travelers with proof of a booster dose do not need to present negative COVID-19 test results.Others are required to showhttps://bw.usembassy.gov/covid-19(Last
Bostswana proof of a negative PCR COVID-19 test within 72 hours of travel and must submit to vaccination on arrival at the Port of Entry.
information/
updated: 06/22/2022)

Brazil

Fully vaccinated travelers are not required to present proof of negative COVID-19 test results before traveling to Brazil.

https://www.in.gov.br/en/web/dou//portaria-interministerial-n-670-de-1-deabril-de-2022-390351794

Brunei

In view of the opening of borders via air travel on 6th May 2022, the COVID-19 Steering Committee would like to inform the public on theeasing of cross-border travel restrictions and the updates of control measures which will also commence on Wednesday, 15th June 2022,
as follows:1)Pre-departure swab test (either (RT-PCR or ART test) for inbound travellers is no longer required, regardless of vaccination status.
2)Fully vaccinated travellers are no longer required to undergo ART testing and self-isolation upon arrival in the country.
3)Travellers who have not completed the COVID-19 vaccination are required to undergo ART testing upon arrival, three (3) days selfisolation and will only be allowed to end their self-isolation if tested negative RT-PCR on day three.( Last updated: 06/09/2022)

https://www.bruneitourism.com/covid19travellers-advisory/Bulgaria

Burkina Faso

As of 1 May 2022, the restrictions on entry into the territory of the Republic of Bulgaria are lifted.
Fully vaccinated travelers are not required to have a negative COVID-19 test result before traveling to Burkina Faso.(Last updated:06/03/
2022)

https://coronavirus.bg/bg/azsum/zavrashtam-se-bulgaria

https://www.sante.gov.bf/covid19

If you’re fully vaccinated, you can enter Cape Verde without needing to test or quarantine but you will need to present proof of yourvaccination status when you check-in for your flight to Cape Verde. If you’re not fully vaccinated, you’ll need to show proof of a negative
PCR test (taken no more than 72 hours before you travel) or an antigen test (taken no more than 48 hours before you travel) when you
https://www.gov.uk/foreign-travelCabo Verdecheck-in for your flight to Cape Verde. If you’re not fully vaccinated but have tested positive for COVID-19 in the last year, you can enteradvice/cape-verde/entry-requirements
Cape Verde with a COVID-19 recovery certificate showing you recovered from COVID-19 no less than 11 days and no more than 180 days
before you travel.

Cambodia

CanadaAs of March 17 2022, the Royal Government of Cambodia has officially decided as follow: 1)Lift the requirement that travelers from abroad
https://www.embassyofcambodiadc.org/
shall present a negative PCR Test Result of COVID-19 within 72 hours prior arriving in Cambodia. 2)Lift the requirement for Antigen Rapid
embassy-updates/pr-no-098-easing-ofTest upon arrival in Cambodia. 3) Resume the issuance of Visa on arrival for international travelers by air, land and sea.
entry-requirements-march-17-2022
Starting April 1, 2022, pre-entry tests are no longer required for fully vaccinated travellers entering Canada by land, air or water.
Unvaccinated and partially vaccinated children 5 years of age or older must provide a valid pre-entry test result, even if they areaccompanying a fully vaccinated adult.

https://www.embassyofcambodiadc.org/
embassy-updates/pr-no-098-easing-ofentry-requirements-march-17-2022

Children who are less than 5 years old are not required to test, regardless of their vaccination status.

Chad

If you’re fully vaccinated, you can enter Chad without needing to test or quarantine.You must present proof that you have been fully
vaccinated to enter Chad.If you’re not fully vaccinated, you’ll need to show proof of a negative PCR test (taken no more than 96 hours
before entry) in order to enter Chad.

https://www.gov.uk/foreign-traveladvice/chad/entry-requirements

Colombia

International travelers who entered Colombia should not present a negative PCR test to enter the country. They only have to do their
Check-Mig registration 24 hours before their flight at the following link: migracioncolombia.gov.co.

https://colombia.travel/en/covid-19information

Cook Islands From 1 May, pre-departure testing has been removed for all international arrivals

https://cookislands.travel/entry

Costa Rica

Starting April 1, the temporary migration measures established in the framework of the national health emergency due to COVID-19 are
repealed.

https://www.visitcostarica.com/en/costarica/planning-your-trip/entryrequirements

Côte d’Ivoire

With effect from 7 March 2022, the Ministry of Health, Public Hygiene and Universal Health Coverage has announced that you no longer
need to show a negative PCR test as long as you can prove that you are fully vaccinated. If you are not fully vaccinated, you will still needto show evidence of a negative COVID-19 test result, dated a maximum of 72 hours prior to arrival, before being allowed to board yourflighthttps://www.gov.uk/foreign-traveladvice/cote-d-ivoire/entryrequirements

Croatia

Croatia removed all border crossing restrictions, notably the requirement for non-EU citizens to present a COVID-19 certificate or proof of
vaccination for entry to Croatia. There are no longer any COVID-related restrictions for entry to Croatia.(Last updated: 06/24/2022)

https://hr.usembassy.gov/covid-19information/Cuba

In accordance with the international and national epidemiological situation of COVID-19 and the levels of immunization achieved, it has
been decided to make the following modifications to the entry requirements to the country as part of the International Health Control.
1)
Eliminate as a requirement for entry to the country the presentation of a test for COVID-19 (Antigen Test or PCR-RT) carried out in thehttps://www.mintur.gob.cu/protocolos/
country of origin, as well as the certificate of vaccination against COVID-19.2) Maintain the sampling for SARS CoV-2 study (free)randomly to travelers at the points of entry into the country, taking into account the number of flights, the entry of boats and theepidemiological risk represented by the country of origin.

Cyprus

Effective 1 June 2022, all travellers arriving in the Republic of Cyprus, irrespective of their country of origin, will not be required to present
a valid certificate of vaccination or recovery or a negative result from a PCR or antigen rapid test.

Czechia

https://www.mvcr.cz/mvcren/article/asAs of 9th April 2022, the protective measures regarding the conditions of entry into the Czech Republic in relation to the epidemic of covidof-december-27th-2021-the-rules-for19 have been suspended. Entry into the Czech Republic is no longer subject to any special epidemiological conditions to prevent theentry-into-the-czech-republic-will-bespread of the disease. The entry-ban for foreigners from third-countries and the obligation to prove infection-free status have been lifted.
tightened-for-foreign-nationals.aspx

Denmark

There are no covid-19 related restrictions on entry into Denmark. On this page, you will find information on testing and everyday
precautions.(Updated: 4 July 2022)

https://www.pio.gov.cy/coronavirus/uploads/27052022_airportsportsactionplana
bolished_EN.pdf

https://en.coronasmitte.dk/travelrules/covidtravelrules

As of April 4th, travellers will no longer be required to fill and submit the pre-travel online form.
Dominica

https://discoverdominica.com/en/travelThe requirement for pre-arrival testing, and testing on arrival for vaccinated travellers at all ports of entry, including seafarers and yachters, advisory-for-dominica
has been removed.

Dominican As of April 23, 2022, all passengers and crew members do not need to present a COVID-19 Vaccination Card, PCR, or antigen test to
Republic enter the Dominican Republic or to enter tourist centers, any establishments or to receive services such as excursions.

Egypt

El Salvador

https://www.godominicanrepublic.com/newsroom/coronavirus/

All passengers traveling to Egypt (including Egyptians) must be in possession of a vaccination certificate or a negative PCR, Antigen Rapid
https://eg.usembassy.gov/u-s-citizenTest, or ID NOW test result for COVID-19 with Quick Response (QR) code, taken at a maximum of 72 hours before their flight departure
services/covid-19-information/
time.(Last updated: 06/12/ 2022)

The Government of El Salvador has removed COVID-19 testing/vaccination requirements for entry. Visitors are advised however to bring
proof of vaccination with them, as this may be requested for entry into certain events or locations in El Salvador.

https://www.dfa.ie/travel/travel-advice/az-list-of-countries/el-salvador/

Estonia

COVID-19 travel restrictions have been lifted in Estonia. Travellers are not required to provide proof of vaccination, recovery from COVID- https://www.visitestonia.com/en/covid19 or a negative test result.
19-and-travelling-to-estonia

Eswatini

As at March 2022, Eswatini is open to all visitors based on the following requirements:
Travellers entering and exiting the Kingdom of Eswatini must produce EITHER of the following, upon arrival at the Points of Entry:
A valid COVID-19 vaccination certificate (hard or electronic) and must be fully vaccinated.
OR
A valid negative COVID-19 PCR test result (hard or electronic) that is not older than 72 hours, for the unvaccinated.

https://www.thekingdomofeswatini.com/travel-advice/Ethiopia

Passengers age 12 and over who have been fully vaccinated against COVID-19 more than two weeks before the date of entry are required
to show evidence of this. Accepted vaccinations are a single dose of Johnson and Johnson, or two doses for Astra-Zeneca, Sinopharm,
Sinovac, Moderna and Pfizer.Travellers under the age of 12 do not need to show proof of vaccination.
If you’re not https://www.gov.uk/foreign-traveladvice/ethiopia/entry-requirements
fully vaccinated, you’ll need to show proof of a negative COVID-19 RT PCR test result issued within the 72 hours (3 days) before
departure, or a rapid lateral flow test up to 24 hours before arriving in Ethiopia.
Restrictions on entry at Finland’s external borders imposed due to the COVID-19 pandemic will end on 30 June, 2022.

FinlandThis means that EU travellers, Schengen travellers and third-country travellers arriving in Finland will no longer be required to holdvaccination or COVID-19 test certificates, and COVID-19 tests will not be carried out at border crossing points.

https://www.visitfinland.com/en/practicaltips/covid-19/

Border checks will return to pre-pandemic procedures.
Covid-19 restrictions at the French border were eased on 12 February 2022 for fully vaccinated travellers.
The entry conditions to French territory are defined by the classification of departure countries (countries and territories on ’green’ and’orange’ lists) indicated below. Children under 12 years of age are exempt from testing.(Updated on June 13th, 2022)
Francehttps://www.diplomatie.gouv.fr/en/coming-to-france/coming-to-france-your-covid19-questions-answered/article/comingto-france-your-covid-19-questionsanswered?var_mode=calcul

Gabon

Travelers are not required to take a negative COVID-19 test (PCR and/or serology) result.(Last updated: 06/13/2022)

https://ga.usembassy.gov/u-s-citizenservices/coronavirus-update/GambiaAs of December 11, 2021, the Ministry of Health updated entry requirements into The Gambia:
Fully vaccinated travelers into The Gambia do not need a PCR test to enter. However, if such individuals have signs or symptoms similar
to those of COVID-19, they will be required to undergo Rapid Diagnostic Test for COVID-19 at the airport.
Non-Vaccinated or Partially Vaccinated individuals will need a negative PCR test report valid within 72 hours for entry into the country.
Individuals who test positive for COVID-19 upon arrival, will be required to undergo mandatory quarantine at the traveler’s own
expense.(Last updated: 06/14/2022)

https://gm.usembassy.gov/covid-19information/

Georgia

From March 1, 2022, citizens of all countries, traveling by air, land, or sea from any country may enter Georgia if they present the
document confirming the full course of any COVID-19 vaccination OR present a negative PCR test taken within 72 hours (96 h)https://georgia.travel/en_US/article/covi
d-travel-alert

Germany

Lifting of COVID-19-related restrictions for entry into Germany with effect as of Saturday, 11 June 2022, 12pm/0.00h CET

https://www.bmi.bund.de/SharedDocs/fa
qs/EN/topics/civilprotection/coronavirus/coronavirusfaqs.html

Ghana

Vaccinated travelers do not need to show a negative COVID-19 test.(Last updated: 06/13/2022)

https://gh.usembassy.gov/ghana-covid19-information/

GreeceFrom 15 March 2022 onwards, travellers visiting Greece are no longer required to fill out the Passenger Locator Form (PLF).
Additionally, as of Sunday 01.05.2022 and for as long as the epidemiological data allow so, all travellers arriving in Greece, regardless of
their country of origin, are no longer required to display a valid certificate of vaccination or recovery from COVID-19, or evidence of anegative test result from SARS-CoV-2 infection (PCR or Rapid Antigen test).

https://travel.gov.gr/#/GrenadaState of emergency revoked and all travel protocols lifted on 04th April 2022. (Last updated: 6/08/2022)

https://bb.usembassy.gov/covidinformation-grenada/Effective March 11, 2022, the Government of Guatemala has imposed the following COVID-related entry requirements:
Passengers who are Guatemalan citizens, foreigners, residents, accredited diplomats, or airline crew whose final destination is Guatemalamust present one of the following:https://gt.usembassy.gov/alert-covid-19Guatemala For all travelers aged 12 and over: Evidence of receiving a complete two-dose COVID-19 vaccination course (or one dose for Johnson &2/Johnson), with the final dose being administered at least two weeks before beginning your trip to Guatemala; or
For all travelers aged 10 and over: Proof of a negative COVID-19 PCR or antigen test from a certified lab conducted no more than three(3) days prior to check in at the airport or arrival at the land border.

GuineaHaiti

Honduras

Hungary

The Ministry of Health announced on 11 March 2022 that fully vaccinated travellers entering or leaving Guinea are not required to show
proof of a negative certificate from a polymerase chain reaction (PCR) test.
Haiti is putting new COVID requirements in place as of April 25, 2022. Fully vaccinated visitors will no longer need to present a negative
COVID-19 antigen or PCR test taken within 72 hours of travel. But the testing requirement will stay in place for unvaccinated visitors.

https://www.gov.uk/foreign-traveladvice/guinea/entry-requirements#entryrules-in-response-to-coronavirus-covid19
https://www.mspp.gouv.ht/

https://hn.usembassy.gov/covid-19Effective June 2, 2021, The Government of Honduras has updated its requirements for entry into the country. All travelers must still
information/complete the online pre-check form, but fully vaccinated individuals with their original vaccination certificate are no longer required toprovide proof of a negative COVID test upon entry in Honduras.
1)Proof of Full Vaccination: Passengers must provide the original vaccination certificate documenting complete COVID-19 vaccination(two doses of most vaccines; one dose of Johnson & Johnson) with at least 14 days after receipt of the final dose.
2)COVID-19 Test: Passengers who cannot provide proof of full vaccination must hand-carry the negative test results for a PCR, Antigen
or ELISA COVID-19 test taken less than 72 hours before entry into Honduras. Passengers must show the test results at check-in.
(Last updated: 6/13/2022)
On 7 March 2022, Government Decree No. 77 of 2022 (III. 4.) on the termination of certain safety measures against the coronavirus
https://www.police.hu/en/content/for-thepandemic entered into force, which repealed Government Decree No. 408 of 2020 (VIII. 30.) on travel restrictions during the period of state attention-of-travelersof epidemiological preparedness.
In accordance with this, it is possible to enter the territory of Hungary by public road, railway, water and air traffic – regardless of citizenshipand protection against the coronavirus –, but other general conditions of entry (e.g. a valid travel document) must be provided.

Iceland

There are no COVID-19 restrictions in Iceland, either domestically or at the border.

India

GuidelinesforInternationalarrivalsupdate
All travellers should Upload a negative COVID-19 RT-PCR report* (The test should have been conducted within 72 hrs prior to undertaking
don10thFebruary2022.pdf
the journey) or Certificate of completing full primary vaccination schedule of COVID-19 vaccination(mohfw.gov.in)

Iraq

Effective April 1, 2022, outbound and inbound travelers above the age of 12 to all federal Iraq and Iraqi Kurdistan Region airports must
present a certificate of vaccination showing at least two doses of one of the COVID-19 vaccines or one dose of Johnson & Johnson’s
Janssen COVID-19 vaccine. If a traveler is unvaccinated, then they are required to provide medical reports on why they cannot get
vaccinated and show a negative COVID-19 PCR certificate valid within 72 hours of travel.(Last updated: 05/15/2022)

Ireland

From Sunday 6 March 2022, travellers to Ireland are not required to show proof of vaccination, proof of recovery or a negative PCR test
result upon arrival.
There are no post-arrival testing or quarantine requirements for travellers to Ireland.

https://island.is/en/p/entry

https://iq.usembassy.gov/covid-19information/
https://www.gov.ie/en/publication/77952government-advice-on-internationaltravel/#passengers-arriving-into-irelandfrom-outside-eueea-eu-icelandlichtenstein-and-norwayAs of Friday, May 20, at midnight (on the night between Friday and Saturday, May 21), the following guidance will take effect:
Isrealhttps://corona.health.gov.il/en/abroad/ar
It will not be required to present a negative result on a COVID test before boarding a flight to Israel or a cruise to Israel or before arriving at riving-foreign-nationals/
an Israeli land border crossing.

Italy

https://www.esteri.it/en/ministero/normat
COVID-19 travel restrictions have been lifted in Italy. Providing proof of vaccination, recovery from COVID-19 or negative test results is no
ivaonline/focus-cittadini-italiani-in-rientrolonger required.
dall-estero-e-cittadini-stranieri-in-italia/

Jamaica

The requirement for travellers to present a negative COVID test prior to travel has ended on 15 April. All travellers arriving in Jamaica may
https://www.gov.uk/foreign-travelstill be tested for COVID-19 if assessed as high-risk as a result of exhibiting symptoms, exposure to people who have tested positive,
advice/jamaica/entry-requirements
belonging to a high-risk group or other risk factors. Travellers may be screened for symptoms at the airport.

JordanThe government announced on 17 Feb 2022 that travelers to the Kingdom, whether Jordanians or foreigners, are no longer required toundergo a PCR test upon arrival to the Kingdom via any entry point.

Kazakhstan Travelers are not required to have a negative COVID-19 test result before traveling to Kazakhstan.(Last updated: 06/13/2022)

http://international.visitjordan.com/MediaCenter/ShowNews/33#news
https://kz.usembassy.gov/covid-19information/

Kenya

FROM 11th March 2022, All travelers arriving into Kenya through any point of entry must have a certificate of COVID 19 vaccination.All
travelers coming to Kenya who are fully vaccinated shall be exempt from the requirement of a PCR test.

https://www.kcaa.or.ke/sites/default/files/covid-19/documents/COVID19_TRAVEL_REQUIREMENTS_13.3.2
022.pdf

KuwaitNegative COVID-19 test (PCR) is no longer required for entry.(Last updated: 06/12/2022)

https://kw.usembassy.gov/covid-19information/

Travelers no longer need to provide a negative PCR test result or a certificate of vaccination to be permitted entry into the Kyrgyz
Republic(Last updated: 6/14/2022)

https://kg.usembassy.gov/covid-19information/

Kyrgyzstan

Laos

Travelers must have a certificate of vaccination to prove that they are fully vaccinated. Fully vaccinated travelers are not required to have https://la.usembassy.gov/covid-19a negative COVID-19 test result before arrival in Laos.(Last updated: 06/13/2022)
information/

LatviaFrom April 1, when entering Latvia, you will not need a COVID-19 certificate or test.

https://www.spkc.gov.lv/lv/valstusaslimstibas-raditaji-ar-covid-19-0

LebanonFully vaccinated travelers are not required to have a negative COVID-19 test result before traveling to Lebanon.

https://www.moph.gov.lb/en/MoPHPAS
S

Lithuania

FROM 1st MAY 2022:
Travelers arriving in Lithuania from any country of the world will no longer be subject to any COVID-19 management requirements:
1)you will no longer need to take the COVID-19 test before the trip, even if you are not vaccinated or recovered from COVID-19;
2)you will not need to fill in the questionnaire;3)foreigners are not prohibited from entering.

https://nvsc.lrv.lt/en/information-oncovid-19/for-arrivals-from-abroadLuxembourg

From 22 April 2022, the additional health measures for travel by air to the Grand Duchy are repealed. Thus, persons (of all nationalities)
aged 12 years and 2 months or over, authorised to enter Luxembourg, are no longer required to present, upon boarding, a vaccination
https://covid19.public.lu/en/travellers/vis
certificate, a certificate of recovery or the negative result of a nucleic acid amplification test (NAAT) for the detection of SARS-CoV-2 viral iting-luxembourg.html
RNA carried out less than 48 hours before the flight, or of a SARS-CoV-2 rapid antigen test carried out less than 24 hours before the flight.

MalawiAs from 1 June 2022, all travellers that are fully vaccinated will no longer be required to produce negative PCR tests. All travellers that are
https://www.malawitourism.com/travelnot fully vaccinated or don’t have a valid electronically verifiable COVID-19 full vaccination certificate will be required to produce a negative
advice/PCR based COVID-19 certificate that is not older than 72 hours at the time of arrival in the country.

Malaysia

Starting 1 May 2022, fully-vaccinated inbound travellers are no longer required to undergo pre-departure and on-arrival COVID-19 tests,
including children aged 12 and below as well as for those who have been infected with COVID-19 within six to 60 days before departure to https://www.malaysia.travel/travel-alert
Malaysia.

Maldives

Effective from March 13th, 2022, PCR is not mandatory to enter the Maldives.

https://immigration.gov.mv/faq-forvisiting-the-maldives/Mali

To enter Mali you will need proof of a “complete COVID vaccination” (i.e. usually at least two doses). If you do not have proof of a complete https://www.gov.uk/foreign-travelvaccination, you need to present a negative COVID test (PCR) certificate less than 72 hours old.
advice/mali/entry-requirements

Malta

As from 6th June 2022, persons aged 12 years and over are permitted to travel to Malta without undergoing quarantine as long as they
https://deputyprimeminister.gov.mt/en/h
provide either of the 3 documents mentioned below:1)Proof of full vaccination. 2) Proof of recovery from COVID-19. 3) Negative result to a ealth-promotion/covidpre-departure test.
19/Pages/travel.aspx

MexicoTravelers are not required to provide proof of a negative COVID-19 test result before traveling to Mexico. Travelers who are connecting
through a different country on the way to Mexico should check the testing requirements of the country they are transiting through.

https://embamex.sre.gob.mx/eua/index.
php/en/2016-04-09-20-4051/tourism/1760-mexico-s-covid-19monitoring-system

MonacoAnyone aged 16 or over, whatever their nationality, who enters the Principality and comes from a foreign country classified in the green
zone must present:
1) Either the negative result of a PCR or antigen test of less than 24 hours
2) Or a complete vaccination;3) Or proof of a covid19 recovery certificate: positive PCR test older than 11 days and less than 6 months.

https://covid19.mc/en/travel/i-comefrom-abroad/

Mongolia

COVID-19 related restrictions for entry have been lifted. Negative COVID-19 PCR tests before and after arrival are no longer required.

https://www.gov.uk/foreign-traveladvice/mongolia/entryrequirements#entry-rules-in-responseto-coronavirus-covid-19

Montenegro

As of March 11, 2022 no proof of vaccination, COVID-19 passports/certificates or COVID-19 tests are required to enter Montenegro. (Last https://me.usembassy.gov/covid-19information/
updated: 06/13/22)

MoroccoTravelers wishing to travel to Morocco, by any means, must present a health form, to be downloaded online before boarding, duly
completed. It is also distributed on board the airport or ship.
They must also present a valid vaccination passport or a negative PCR test result less than 72 hours old.
Children under the age of 12 are exempt from all requirements.

https://www.onda.ma/Je-suisPassager/Guide-du-voyageur/Newsa%C3%A9roportuaires-COVID19

Mozambique

PCR test is no longer needed to enter the country if a person presents a valid certificate showing proof of full vaccination against COVID19. In addition, children 11 and younger do not require a PCR test or proof of vaccination to enter the country.(Last updated: 06/13/2022)

https://mz.usembassy.gov/covid-19information/

Namibia

Fully vaccinated travelers are no longer required to produce a negative PCR test result upon arrival in Namibia but are instead required topresent an authentic, valid vaccination card at the port of entry. Travelers who are not fully vaccinated must produce a negative COVID-19
https://na.usembassy.gov/covid-19Polymerase Chain Reaction (PCR) test result no older than 72 hours from their arrival in Namibia calculated from the date/time the sample
information/
was taken. The certificate must be issued by a certified laboratory to issue SARS-Co V-2 test results in the country of issuance.
(Last updated: 07/05/2022)

Nepal

Effective March 10,2022, passengers entering Nepal from abroad by air or land must submit a certificate of full vaccination against COVIDhttps://www.immigration.gov.np/post/not
19.Passengers who fail to submit such certificate will have to submit the certificate with nagative report of COVIS-19 test(RTPCR, True
ice-5
NAAT, Gene Xpert) within 72 hours of starting the journey.

Nertherlands

There are no coronavirus-related restrictions for entering the Netherlands for travellers who live in the EU/Schengen area or in a country
https://www.government.nl/topics/coronparticipating in the EU travel rules scheme. The EU entry ban applies to other travellers who live outside the EU/Schengen area, but there
avirus-covid-19/visiting-the-netherlandsare exemptions to the entry ban. For example, if you come from a safe country, or you have a proof of vaccination or proof of recovery thatfrom-abroad/checklist-entry
meets the requirements.

Niger

Travelers on arrival (disembarkation): For vaccinated travellers whose last dose is at least 4 weeks old, the COVID-19 PCR Test is nolonger required; For travellers who have not been vaccinated or who have not provided proof of vaccination whose last dose is at least 4
weeks old, the COVID-19 PCR Test is required.

Effective from 4th April 2022, as detailed below:
1)Fully vaccinated passengers arriving in Nigeria will not be required to carry out a pre-boarding COVID-19 PCR test nor carry out a Postarrival PCR test or Rapid Antigen Test upon arrival in Nigeria.
Nigeria2)Fully vaccinated passengers must show a verifiable full vaccination certificate otherwise, they will be treated as unvaccinated/partially
vaccinated under this protocol.
3)Unvaccinated and partially vaccinated passengers are required to take a COVID-19 PCR test 48hrs before departure and conduct days
2 and 7 post-arrival PCR tests. Such passengers will be expected to pay for their PCR tests through the NITP
Fully vaccinated travelers are not required to provide proof of a negative COVID-19 test result before traveling to Northern Macedonia. All
North
passengers coming from the medium- and high-risk countries must be in self-isolation for 14 days in their homes and to report to theMacedonia
authorities should they feel any symptoms.

https://www.gouv.ne/index.php/lescommuniques-du-gouvernement/296-auconseil-des-ministres-le-gouvernementreitere-son-engagement-a-remplacerles-salles-de-classe-en-paillote-par-dessalles-de-classe-en-materiaux-definitifs

https://covid19.ncdc.gov.ng/advisory/https://koronavirus.gov.mk/en/seek-helpor-report-irregularities/application-forpeople-returning-from-travels

NorwayThere are no longer special requirements for entry into Norway due to the corona situation. The same rules as before the corona pandemic https://www.udi.no/en/corona/about-theapply now.
corona-situation/

Oman

https://www.omanairports.co.om/news/u
Non-citizen travelers aged 18 and above traveling to the Sultanate of Oman are required to present a vaccination certificate indicating that
pdate-on-travel-restrictions-related-tothey have received at least two doses of the approved COVID-19 vaccine at least 14 days before traveling.
covid-19/

Pakistan

PanamaVaccinated individuals do not require a pre-boarding negative PCR test. Unvaccinated individuals over age 12 must present a negative
PCR test taken within 72 hours.
Last update on April 6, 2022.Travelers will not have to present a negative COVID-19 test for entry as long as they can provide physical ordigital proof of at least 2 (two) doses or complete vaccination scheme endorsed by the WHO, EMA and FDA, equal to or greater than 14days after the last dose.

https://pk.usembassy.gov/covid-19information/

https://www.tourismpanama.com/planyour-vacation/advisories/

Non-vaccinated or partially vaccinated travelers will be required to present a negative COVID-19 PCR or antigen test taken no more than
72 hours prior to their arrival time in Panama.

ParaguayPeru

https://www.migraciones.gov.py/index.p
Fully vaccinated travelers are not required to present a negative COVID-19 test result before traveling to Paraguay, in force as of April 19, hp/tramites/ingreso-y-salida-del2022.
pais/exigencias-sanitarias-vigentes-porcovid-19-para-el-ingreso-al-paraguay

Travelers with valid proof of being fully vaccinated are not required to have a negative COVID-19 test result before traveling to Peru.

https://busquedas.elperuano.pe/normas
legales/decreto-supremo-que-modificael-decreto-supremo-n-184-2020-decretosupremo-no-151-2021-pcm-1988484-1/

Philippines

Fully vaccinated travelers over the age of 18 who have received the primary series of COVID-19 vaccine and at least 1 COVID-19 booster
shot are not required to have a negative pre-departure COVID-19 test result before traveling to the Philippines. Travelers aged 12 to 17
https://www.philippineairlines.com/en/ph
who have received their primary COVID-19 vaccines are not required to have a negative pre-departure COVID-19 test result before/home/covid-19/arrivinginthephtraveling to the Philippines.(Last updated: 06/02/ 2022)

PolandFrom 28 March 2022, on the basis of the provisions of the Regulation of the Council of Ministers of 25 March 2022 on the establishment ofcertain restrictions, orders and prohibitions in connection with the occurrence of the state of epidemic (Journal of Laws item 673), all
restrictions on travel to the Republic of Poland are abolished, which means that there is no longer an obligation to:https://www.gov.pl/web/koronawirus/info- to present vaccination certificates when crossing the border,
rmacje-dla-podrozujacych- performing tests for SARS-CoV-2,- the so-called arrival quarantine.

Portugal

As of July 1, 2022, passengers entering national territory (including Azores and Madeira) are no longer required to present proof of carrying
https://www.visitportugal.com/en/node/4
out a test to screen for SARS-CoV-2 infection with a negative result or to present a COVID-EU digital certificate or vaccination or recovery
46781
certificate issued by third countries, accepted or recognized in Portugal.

RomaniaSaint Lucia

Visitors and residents arriving to Romania from any country in the world do not need to present proof of vaccination (complete scheme) ora negative RT-PCT test.(Last update: July 4, 2022)

Updated entry requirements effective 2 April 2022, There is no requirement for pre-travel test or quarantine for fully vaccinated travellers.
Fully vaccinated travellers must provide a valid vaccination record as requested on check in, for boarding and on entry to Saint Lucia.

https://romaniatourism.com/traveladvisory.html

https://www.stlucia.org/en/covid-19/

SaintVincent and Fully vaccinated travelers to St. Vincent and the Grenadines DO NOT NEED TO ARRIVE WITH A SARS-CoV-2 (COVID-19) TEST(Last
updated:06/15/2022)
theGrenadines

http://health.gov.vc/health/index.php/co
vid-19-protocols-documents

Health Minister Roberto Speranza has signed a new ordinance establishing, with effect from 1 March, the same rules for arrivals to Italy
from all non-European countries as those already in force for European countries. For entry to the national territory,

https://www.salute.gov.it/portale/nuovoc
oronavirus/dettaglioContenutiNuovoCor
onavirus.jsp?lingua=english&id=5412&a
rea=nuovoCoronavirus&menu=vuoto

San Marino

The requirements for entry into Sao Tome and Principe (STP) require passengers - of all nationalities - from the age of 12, who are not with https://portaldascomunidades.mne.gov.
Sao Tome
the full digital vaccination certificate, to submit a negative antigen test, performed up to 48 hours before the date of travel. Those with apt/pt/vai-viajar/conselhos-aosand Principe
valid digital certificate are exempt from the presentation of the antigen test.(Last updated: 05/06/2022)
viajantes/africa/sao-tome-e-principe
The Saudi Arabian Government will allow travelers from all countries to enter the Kingdom if they are fully vaccinated (with booster for
vaccines with which it is required) with an approved COVID-19 vaccine, including: Pfizer, Moderna, Oxford AstraZeneca, Johnson andSaudi Arabia
Johnson, Sinopharm, Sinovac, Covaxin, Sputnik and Covovax.Negative COVID-19 test (PCR and/or serology) is not required for entry to
Saudi Arabia.(Last updated: 04/12/2022)
All travelers to Senegal over the age of two years must present either a:1) COVID-19 vaccination certificate showing that they were fully vaccinated with AstraZeneca (SK Bioscience or Vaxzevria), Covishield,
Janssen J&J, Moderna, Pfizer-BioNTech, Sinovac, or Sinopharm at least 14 days before departure; orSenegal2)A negative COVID-19 PCR or RT-PCR test result issued at most 72 hours before departure. The test result must be in English or
French.( Last updated: 06/03/2022)
There are no restrictions on entering the Republic of Serbia.(Last updated 05/03/2022)
Serbia• All fully immunised visitors are exempted from pre-travel PCR test requirement upon presentation of their vaccination certificate.
• Unvaccinated or partially vaccinated visitors will be required to present a negative PCR test certificate from an accredited laboratory
Seychelles departure to Seychelles. Samples for this test must have been taken within 72hours before departure for PCR test and 24 hours for rapid
antigen test.(Last updated:03/15/ 2022)

https://sa.usembassy.gov/u-s-citizenservices/covid-19-information/

https://sn.usembassy.gov/covid-19information/

https://www.mfa.gov.rs/en/citizens/travel-serbia/covid-19-entry-requirements
http://tourism.gov.sc/wpcontent/uploads/2022/03/SeychellesVisitor-Travel-Advisory-15-March-20221.pdf

Vaccinated passengers do not require a pre-departure or on arrival PCR test.
Unvaccinated or partially vaccinated passengers do not require a pre-departure PCR test. They do however require an on arrival PCR test https://www.gov.uk/foreign-traveladvice/sierra-leone/entrySierra Leone that should be booked and paid for in advance of departure through the Government of Sierra Leone travel portal.
requirements#entry-rules-in-responseto-coronavirus-covid-19

Singapore

Slovakia

Fully vaccinated travelers are not required to provide proof of a negative COVID-19 test result to enter Singapore.
If
you are Non-Fully Vaccinated Travellers and born before 2020 (i.e. above 2 years old) , take any of the following COVID-19 tests within 2 https://safetravel.ica.gov.sg/arriving/gendays before departure: COVID-19 Polymerase Chain Reaction test (PCR test) ; Antigen Rapid Test (ART)eral-travel/fully-vaccinatedFrom 6 April 2022, the Decree of the Public Health Authority of the Slovak Republic No. 28/2022 regulating the regime at the borders is
repealed. Thus, the obligation to register on eHranica as well as the mandatory quarantine for unvaccinated persons immediately after the https://www.mzv.sk/web/en/covid-19
arrival from abroad are abolished.

Slovenia

As of 14 May 2022, the RVT rule is no longer required.Free testing with a rapid antigen test and a rapid antigen test for self-testing isabolished. The government budget will only pay for testing with a rapid antigen test for activities where this is still required.

https://www.gov.si/en/topics/coronavirusdisease-covid-19/border-crossing/From 4 May 2022, All international travellers arriving at South African Ports of Entry must:(a) be vaccinated against COVID-19 and produce a valid vaccination certificate; or(b) produce a valid certificate of a negative PCR COVID-19 test, recognised by the World Health Organization, which was obtained not
more than 72 hours before the date of departure; or(c) produce a valid certificate of a negative antigen COVID-19 test performed by a medical practitioner, registered public health authority or https://www.gov.za/covid-19/individualsSouth Africa accredited/approved laboratory which was obtained not more thanand-households/travel-coronavirus48 hours before the date of departure; or
covid-19(d) produce a valid certificate of a positive PCR COVID-19 test, recognised by the World Health Organization, for a test date less than 90days prior to the date of arrival and more than 10 days prior to the date of arrival, together with a signed letter from a health care provider,registered in the country of origin, stating that the person has fully recovered from COVID-19, is not experiencing any new symptoms andis fit to travel.

Spain

Sri Lanka

Passengers arriving in Spain by AIR (except children under the age of 12 and passengers in international transit) from countries that DO
NOT belong to the European Union or are NOT considered Schengen associated countries, must have one of these documents:
1)DIGITAL COVID CERTIFICATE OR EU EQUIVALENT; 2)QR SPTH.

https://www.sanidad.gob.es/en/profesio
nales/saludPublica/ccayes/alertasActual/nCov/spth.htm

Fully Vaccinated travellers are exempted from pre-departure COVID-19 PCR/ Rapid Antigen tests from 1st March 2022. Not-Vaccinated &https://srilanka.travel/helloagain/
Not-fully vaccinated Travellers are released from On-arrival PCR test & Quarantine period.

Sudan

The Sudanese Civil Aviation Authority requires all passengers entering Sudan to possess:
1) A COVID-19 vaccination certificate showing that the passenger is fully vaccinated at least 14 days and not more than 8 months before
arrival; or2) A negative polymerise chain reaction (PCR) test certificate taken not more than 72 hours before arrival; or3) A negative polymerise chain reaction (PCR) test certificate taken not more than 96 hours before arrival if arriving from Antigua andhttps://sd.usembassy.gov/covid-19Barbuda, Argentina, Austria, Bahamas, Barbados, Belgium, Belize, Bolivia, Brazil, Bulgaria, Canada, Chile, China (People’s Rep.),
information/
Colombia, Costa Rica, Croatia, Cuba, Cyprus, Czechia, Denmark, Dominica, Dominican Rep., Ecuador, El Salvador, Estonia, Finland,
France, Germany, Greece, Grenada, Guatemala, Guyana, Haiti, Honduras, Hungary, India, Ireland (Rep.), Italy, Jamaica, Latvia,
Lithuania, Luxembourg, Malta, Mexico, Netherlands, Nicaragua, Panama, Paraguay, Peru, Poland, Portugal, Romania, Slovakia, Slovenia,
Spain, St. Kitts and Nevis, Suriname, Sweden, Trinidad and. Tobago, USA, Uruguay or Venezuela.
4) Passengers 8 years old and younger are exempt.(Last Updated: 06/12/2022)

Suriname

Persons who are fully vaccinated or can present a COVID-l9 recovery certifrcate not older than six (6) months and have stayed in Guyana https://www.flyslm.com/wpor French Guyana at least 14 days and are travelling to Suriname by land do not need to submit a Negative SARS-CoV-2 PCR or acontent/uploads/2022/04/SUR-COVIDnegative SARS-CoV-2 antigen test result.(Updated:04/13/2022)
19-Measures-13-April-2022.pdf

Swedenhttps://www.folkhalsomyndigheten.se/th
e-public-health-agency-ofCOVID-19 travel restrictions have been lifted in Sweden. Providing proof of vaccination, recovery from COVID-19 or negative test results is
sweden/communicable-diseasenot required.
control/covid-19/recommendations-forthose-travelling/Switzerland

Syria

There are currently no entry restrictions due to the COVID-19 pandemic. No proof of vaccination, recovery or testing is required for entry
into Switzerland.

https://www.bag.admin.ch/bag/en/home/krankheiten/ausbrueche-epidemienpandemien/aktuelle-ausbruecheepidemien/novel-cov/empfehlungenfuer-reisende/quarantaeneeinreisende.html#-924144951

If you’re fully vaccinated, you can enter Syria without needing to test but you may be required to isolate.If you’re not fully vaccinated, you’ll https://www.gov.uk/foreign-travelneed to show proof of a negative PCR test (taken no more than 72 hours before entry) when entering Syria.(Last updated:05/28/2022)
advice/syria/entry-requirements

Tajikistan

Each traveler aged three years and older must present either
1) a COVID-19 vaccination certificate showing that they are fully vaccinated or2) results from a negative COVID-19 PCR test issued within 72 hours of arrival.
Test results are verified before passengers are allowed to board flights to Dushanbe and again upon arrival in Dushanbe.
(Last updated: 06/28/2022)

https://tj.usembassy.gov/covid-19information/

Thailand

From 1 July, 2022, foreign nationals are only required to show proof of either a certificate of vaccination or a negative RT-PCR or
professional ATK test result within 72 hours of travel.

https://www.tatnews.org/

Togo

For fully vaccinated travellers arriving in Togo, PCR test is no longer required and will not be performed upon arrival either.
For unvaccinated travellers arriving in Togo, proof of a negative PCR test is still required and these passengers will be subjected to a PCR https://voyage.gouv.tg/?language=en#p2
test at arrival.The validity of the PCR test results is 5 days.(Date last modified: 15/04/2022)

Trinidad and Effective 1st July, 2022, COVID-19 PCR or Lab Acquired Antigen Test results will No Longer be required for entry into Trinidad andTobago.
TobagoThe 05-day self-confinement rule is no longer required for foreign visitors over the age of 18 who are not vaccinated or who have notcompleted their vaccination schedule.
Tunisia
However, they are still compelled to present a negative result of a PCR test carried out 48 hours before boarding or of a 24-hour rapid test
prior arriving on Tunisian territory..(Updated 27th May 2022)

https://health.gov.tt/preparation-forentry

https://www.discovertunisia.com/en/infos-pratiques/entry-requirements

TurkeyA PCR test is required for individuals over the age of 12 years old who are unable to show proof of vaccination or are unable to submit adocument stating that they have had the virus within the last 6 months.(Last Updated: 06/132022)

https://tr.usembassy.gov/covid-19information-2/

UgandaIf you are fully vaccinated (and for children under the age of 6) you are now able to enter Uganda via air and land border points without
showing a negative COVID-19 PCR certificate. You will be required to show evidence that you are fully vaccinated.
If https://www.gov.uk/foreign-travelyou are not fully vaccinated you will need to show a negative COVID-19 PCR certificate issued no more than 72 hours before departure on advice/uganda/entryrequirements#entry-rules-in-responsearrival by land or air.
to-coronavirus-covid-19

From 26 February 2022,Those coming to the UAE have to make sure to present an approved QR code- accompanied Covid-19
United Arab vaccination certificate containing a QR code; unvaccinated travelers have to present an approved negative PCR test result received within https://covid19.ncema.gov.ae/en/News/
Details/2316
Emirates 48 hours, or a QR code-accompanied certificate of recovery from a Covid-19 infection obtained within one month from the date of travel.
Travelers from the UAE have to follow the requirements of medical examinations and vaccinations in place in their countries of destination.

United
Kingdom

From 4am 18 March,2022, no-one entering the UK will need to take tests or complete a passenger locator form.

UnitedFully vaccinated travelers are exempt from testing requirements. Travelers will be required to present a valid vaccination certificate with
Republic of
QR code for verification upon arrival.(Last updated on :06/27/2022).
Tanzania
As of 12:01AM ET on June 12, 2022, CDC will no longer require air passengers traveling from a foreign country to the United States toshow a negative COVID-19 viral test or documentation of recovery from COVID-19 before they board their flight. (Last updated onUnited States :06/13/2022)

Uruguay

https://www.gov.uk/government/news/allcovid-19-travel-restrictions-removed-inthe-uk
https://tz.usembassy.gov/covid-19information/

https://www.cdc.gov/coronavirus/2019ncov/travelers/noncitizens-US-airtravel.html

Foreign citizens who are fully vaccinated or have already completed the COVID-19 disease within the last 90 (ninety) days are nothttps://www.gub.uy/ministerio-saludrequired to present a negative COVID-19 RT-PCR or antigen test result before departure to Uruguay.Unvaccinated travelers need to prove publica/comunicacion/publicaciones/req
a negative result of SARS-CoV-2 virus detection test (by molecular biology technique PCR-RT or antigen test), performed no more than 72 uisitos-para-ingreso-uruguay-personas(seventy-two) hours before the start of the trip, in a laboratory enabled in the country of origin or transit.
nacionales-extranjeras

Effective June 10, 2022, COVID testing or proof of vaccination are no longer required to enter Uzbekistan at any air, rail or land entry point.
https://uz.usembassy.gov/covid-19Uzbekistan (Last updated: 06/13/2022)
information/
Effective May 30, 2022, all air passengers entering Venezuela must present a certificate of vaccination against COVID-19 (completed
vaccination schedule) in either physical or digital format (with QR code), with the last dose administered at least 14 days prior to the entry
date in Venezuela. If more than 270 days has passed since the last dose of a completed vaccination schedule, proof of a booster dose isrequired. In lieu of proof of vaccination, passengers must present a negative PCR-RT COVID-19 test result, taken within 72 hours ofarriving. (Last updated: 06/21/2022)

https://ve.usembassy.gov/covid-19information/

Viet Nam

Foreign arrivals will no longer have to take any COVID-19 tests to enter Viet Nam from May 15, 2022, the Government announced Friday.

https://en.baochinhphu.vn/viet-nam-toscrap-covid-19-test-requirements-forvaccinated-entrants-from-mid-may11122051320312898.htm

Zambiahttps://www.zambiaimmigration.gov.zm/
Fully vaccinated traveller do not require any form of negative COVID test results, but shall be requires to provide proof of a full vaccination wpstatus.(Updated:03/23/2022)
content/uploads/2022/03/Revised_Trav
el_Guidelines_Zambia.pdf

Zimbabwe

All ports of entry have been opened. Returning residents & visitors will no longer be required to present a negative COVID19 PCR
certificate at the port of entry but should present a valid Vaccination Certificate showing they are fully vaccinated.

Venezuela

https://zimbabwetourism.net/covid19guidelines-for-travellers/Reopen for International Travel With Required COVID-19 Testing (29 Member States)
Updated on 5 July, 2022
AngolaBurundiChile

Anyone arriving in Angola must present proof of a negative RT-PCR COVID-19 test; passengers may take the test up to 72 hours
prior to travel.(Last updated: 06/14/2022)
All travellers are required the negative COVID-19 test(PCR and/or serology) for entry. The test must be done within 72 hours ofboarding a plane to Bujumbura. All travelers must take a COVID-19 test upon arrival. The cost is $100.
(Last updated: 06/13/2022)
While it is not mandatory, it is always advisable to perform a diagnostic test before traveling.The approval of vaccines to access the
Mobility Pass is voluntary. We recommend processing it, since the pass allows you to enter interior rooms of restaurants, cinemas,
theaters, bus trips, among others.

https://ao.usembassy.gov/covid-19information/
https://bi.usembassy.gov/covid-19information/
https://www.chile.travel/planviajarachil
e/

Congo

If you are a traveler to Congo, you must before your departure from abroad: Pay for the COVID-19 PCR test to be carried out assoon as you arrive at Congo airports (Brazzaville and Pointe Noire).

https://voyage-congo.com/en/

Democratic
Republic ofCongo

If you’re fully vaccinated, Travellers aged 11 and above need to provide proof of a negative coronavirus test upon entry to DRC
and/or proof of vaccination against COVID-19. The test result date must be within the 48 hours prior to your arrival. Children under
the age of 11 are exempt. There is no requirement for a PCR COVID-19 test at the airport upon arrival.If you’re not fully
vaccinated,you will be subject to an additional PCR test on arrival.

https://www.gov.uk/foreign-traveladvice/democratic-republic-of-thecongo/entry-requirements

Djibouti

Even if you are fully vaccinated you will still need to arrive with a PCR test which must have been taken within 72 hours of the startof the journey and 120 hours of arrival in Djibouti. On arrival you will be required to take an additional COVID-19 test at the airport
for which you will pay $30.

https://www.gov.uk/foreign-traveladvice/djibouti/entryrequirements#entry-rules-in-responseto-coronavirus-covid-19

EcuadorAny traveler over 3 years of age must present a mandatory vaccination certificate with QR code or COVID-19 vaccination card valid
https://www.aeropuertoquito.aero/es/pwith at least 14 days of validity after completing the scheme, or the negative result of an RT-PCR test carried out up to 72 hours
rotocolo-covid-19.html
prior to boarding to Ecuador. Passengers under 3 years of age will not present these requirements.

EritreaTravellers, regardless of whether fully vaccinated or not, must have a negative COVID-19 PCR test result. The test must be taken a https://er.usembassy.gov/covid-19maximum of 72 hours before arrival in Eritrea.(Last updated: 05/09/2022)
information/

Fiji

Fiji is quarantine free for fully-vaccinated travellers from all over the world. Travellers (16yrs+) must produce a digital/paper
certification of full-vaccination at least 14 days before travel. All travellers (12 years+) must take a pre-booked Rapid Antigen Test
(RAT) anytime within 72 hours of arrival in Fiji, at their hotel or nearby testing facility. This test must also be taken by travellers
transiting Fiji for more than 48 hours

https://www.fiji.travel/articles/frequentl
y-asked-questions-travelling-to-fiji

Guinea-Bissau

Entry and exit into Guinea-Bissau is permitted only with the presentation of a negative COVID-19 test result (done within 72 hours
from the start of travel) (Last updated: 05/27/2022)

https://gw.usmission.gov/covid-19information/

Guyana

From November 1, 2021, the following COVID 19 measures shall apply as travel requirements for entry into Guyana. The measuresin the Official Gazette (Extraordinary) of Guyana, 235/2021 is applicable with these variations.
https://www.health.gov.gy/images/trav
The following documents are required before travelling to Guyana
el_requirement.pdf
1) Proof of full vaccination
2) Negative SARS-CoV-2 Antigen test not older than 72 hours or a negative SARs-Cov-2 PCR test not older than 72 hours

Indonesia

All foreign nationals entering Indonesia must present a negative PCR test issued a maximum of 2 x 24 hours before departure, as
well as a fully completed Electronic Health Alert Card (eHAC) for contact tracing purposes. All foreign nationals entering Indonesia
must carry out a PCR test upon arrival. Foreign nationals who present a positive PCR test result upon arrival will be transferred to
an isolation or treatment facility by the relevant authorities. Consult the Indonesian government COVID-19 website for fulldetails.(Updated on: 04/29/2022)

https://www.dfa.ie/travel/traveladvice/a-z-list-of-countries/indonesia/

Iran

Travelers must have a negative COVID-19 PCR test result. The test must be taken a maximum of 72 hours before departure. The
results must be in English or approved by an Iranian consulate.

https://caa.gov.ir/covidforms?_gl=1*1ik8cy7*_ga_0NMZLXT
Z77*MTY0NjM1OTE5NS40LjEuMTY0
NjM1OTI3MS4w

Liberia

https://www.nphil.gov.lr/index.php/libe
Travelers must have a negative COVID-19 PCR test result from a test taken a maximum of 72 hours before departure and obtained
ria-health-ministry-introduces-newfrom an accredited laboratory.(Updaed:04/21/2022)
covid-19-protocols-for-travelers/

Libya

A COVID-19 PCR test administered no more than 48 hours prior to travel to Libya is required.(Last updated: 05/10/2022)

Madagascar

Mauritania

Mauritius

Myanmar

Entry requirements update, May 12, 2022:Presentation of a negative result of an Rt-PCR test performed 72 hours before
boarding.Performing a rapid antigen test upon arrival in Madagascar, at the traveler’s expense. In case of a positive result to therapid antigen test on arrival, a 7-day self-isolation at least will be implemented in a dedicated facility, at the traveler’s expense.

A NEGATIVE PCR TEST IS ONLY REQUIRED FOR ENTRY TO MAURITANIA IF YOU LACK PROOF OF FULL VACCINATION.
Fully vaccinated persons are still require to present a negative PCR test result by airlines prior to boarding for Mauritania boundflights. (Last updated: 06/13/22)
1) You must be fully vaccinated to freely explore our island and its attractions throughout your holidayCOVID-19. testing will be
required on arrival (day 0) in Mauritius.
2)
Unvaccinated guests must book a 14-night quarantine stay in an official quarantine hotel.To enter Mauritius, you must present a
negative PCR test taken within 72 hours before departure.You will have a PCR test on arrival, day 7 and day 14. After a negative
PCR test on day 14, you can freely explore the island and move to new accommodation or go home.

All foreign nationals are required to present laboratory evidence of a negative COVID-19 RT-PCR test issued at most 48 hours
before arrival if you are unable to present a COVID-19 fully vaccinated certificate at least 14 days before arrival to Myanmar with
one of the vaccines approved by the Ministry of Health (MOH)l.(Last updated: 06/17/2022)

Lastest updated: 21 June 2022:
1)You do not need a pre-departure test to enter New Zealand.
New Zealand2) Most travellers need to be vaccinated and take 2 rapid antigen tests (RATs) after arriving in New Zealand.

https://ly.usembassy.gov/u-s-citizenservices/covid-19-information/

https://madagascar-tourisme.com/Frfr/border-reopening/https://mr.usembassy.gov/covid-19information-2/

https://mauritiusnow.com/

https://mm.usembassy.gov/covid-19information/

https://covid19.govt.nz/internationa
l-travel/travel-to-new-zealand/predeparture-tests-to-enter-newzealand/

Nicaragua

Palau

Travelers must have an original negative COVID-19 RT-PCR test result. The test must be taken a maximum of 72 hours before
arrival in Nicaragua.

https://www.intur.gob.ni/2020/09/21/ni
caragua-reanuda-vuelos-comerciales/

Travelers must submit proof of complete COVID-19 vaccination with final dose administered at least fourteen (14) days prior to
departure to the Republic.All Travelers must also provide proof of either: a). A negative result of a COVID-19 PCR test (any type of
PCR test, including NAAT, RTPCR, qPCR, RT-LAMP, TMA, molecular test, isothermal amplification, ddPCR, or CRISPR), and suchtest must be taken within three (3) days prior to departure from the point of origin to the Republic; or b). A negative result of a
https://www.palaugov.pw/travel/
COVID-19 antigen test (WHO or US FDA authorized or approved test), and such test must be taken within one (1) day prior to
departure from the point of origin to the Republic; or c). Documentation of recovery from COVID-19 which includes proof of a
recent positive viral test and a letter from a healthcare provider or a public health official stating that traveler has recovered fromCOVID-19 and is cleared to travel.

Papua New
Guinea1) All persons must be fully vaccinated to travel to PNG, unless they are under 18 years of age or are a citizen of Papua New
Guinea. A person is considered fully vaccinated if they have had the recommended number of doses for the vaccine as listed in
Schedule 2, within the past 6 months; or they have had the recommended number of doses for the vaccine, as listed in Schedule 2 https://www.papuanewguinea.travel/tr
and they have had a booster vaccine; 2) All persons traveling to PNG must have a valid COVID-19 test within 72 hours prior to their avel-advice-update
original port of departure. Children aged 5 years and under are exempted from being tested; 3)All people arriving into PNG will betested for COVID-19 upon arrival;

Qatar

Travelers who are required to have a PCR lab result before traveling to Qatar must have it at a medical center authorized by the
https://covid19.moph.gov.qa/EN/travelhealth authorities in the country of departure. A negative test result is required and must be obtained no more than 48 hours before
and-return-policy/Pages/default.aspx
the time of departure from the country of origin. (Please see the pre-travel test rules for detailed guidance.)

Republic of
Korea

All passengers arriving in the ROK by plane must provide proof of a negative COVID-19 PCR test taken within 48 hours of theirdeparture.Arriving passengers will experience some combination of temperature screening, health questionnaires, quarantines,
and/or COVID-tests, depending on points of departure, visa status, and nationality.(Updated:05/11/2022)

https://kr.usembassy.gov/022420covid-19-information/

RussiaFederation

The Russian government requires that all foreign travelers present a negative PCR COVID-19 test result upon arrival, dated nolater than two days prior to arrival in Russia. The results can be in English and/or digital. (Last updated:03/30/2022)

https://ru.usembassy.gov/covid-19information/

RwandaAs part of Government measures to prevent the spread of COVID-19, the following is mandatory upon entry into Rwanda, effective
14th May 2022:
https://www.rbc.gov.rw/index.php?id
Arriving passengers at Kigali International Airport must present a negative Antigen Rapid Test (RDT) taken 72 hours prior to
departure (meaning travelers must be tested and get results within 3 days of their first flight). COVID-19 Test is not mandatory for=745
accompanied children under 5 years. Incoming travelers eligible (aged 12 years and above) for Covid-19 vaccine are encouraged to
be fully vaccinated before their travel. An additional Antigen Rapid Test (RDT) will be taken upon arrival at own cost.

Effective Friday April 1st 2022, all travelers must submit a Rapid Antigen negative test result from a CLIA/CDC/UKAS approved lab
Saint Kitts and accredited with ISO/IEO 17025 standard, taken 1 day prior of your arrival or submit a COVID-19 RT-PCR or NAAT negative test
https://www.stkittstourism.kn/travelresult from a CLIA/CDC/UKAS approved lab accredited with ISO/IEO 17025 standard, taken within 3 days of your arrival, along with requirements
Nevis
the required embarkation form, and all other supporting documentation. An embarkation form is required regardless of age.

1) Per guidance issued on July 25, 2021, by the Ministry of Health in the Republic of South Sudan, travelers must present a valid
SARS-CoV2 PCR negative test certificate with a sample collected not more than 72 hours prior to arrival at the point of entry andhttps://ss.usembassy.gov/covid-19South Sudan with documentation of full COVID-19 vaccinations (completed at least two weeks before traveling) to not require a quarantine
information/
period. 2) Per guidance issued on December 22, 2021, by the Ministry of Health in the Republic of South Sudan, both inbound andoutbound travelers must present both a negative PCR test and proof of vaccination.(Last updated: 06/13/2022)

COVID-19 Weekly Epidemiological Update
Edition 99 published 6 July 2022
In this edition:• Global overview• Special Focus: Update on SARS-CoV-2 variants of interest and variants of concern• WHO regional overviews

Global overview
Data as of 3 July 2022
Globally, the number of weekly cases has increased for the fourth consecutive week, after a declining trend since
the last peak in March 2022. During the week of 27 June to 3 July 2022, over 4.6 million new cases were reported,a figure similar to that of the previous week (Figure 1). The number of new weekly deaths decreased by 12%,with over 8100 fatalities reported.
At the regional level, the number of new weekly cases increased in the Eastern Mediterranean Region (+29%),
the South-East Asia Region (+20%), the European Region (+15%), and the Western Pacific Region (+4%), while itdecreased in the African Region (-33%) and the Region of the Americas (-18%). The number of new weekly deaths
increased in the Eastern Mediterranean Region (+34%) and the South-East Asia Region (+16%), while decreases
were observed in the African Region (-50%), the Region of the Americas (-13%), the European Region (-12%) andthe Western Pacific Region (-12%).
As of 3 July 2022, over 546 million confirmed cases and over 6.3 million deaths have been reported globally.
These trends should be interpreted with caution as several countries have been progressively changing
COVID-19 testing strategies, resulting in lower overall numbers of tests performed and consequently lower
numbers of cases detected.
Figure 1. COVID-19 cases reported weekly by WHO Region, and global deaths, as of 3 July 2022**

20 000 000

Cases

15 000 000

120 000

AmericasSouth-East Asia
EuropeEastern Mediterranean
AfricaWestern Pacific
Deaths100 000
80 00060 000

10 000 000

40 0005 000 000

20 000006-Jan27-Jan17-Feb
09-Mar30-Mar20-Apr
11-May01-Jun22-Jun13-Jul03-Aug24-Aug
14-Sep05-Oct26-Oct16-Nov
07-Dec28-Dec18-Jan08-Feb01-Mar22-Mar
12-Apr03-May24-May14-Jun05-Jul
26-Jul16-Aug06-Sep27-Sep18-Oct08-Nov
29-Nov
20-Dec10-Jan31-Jan21-Feb
14-Mar
04-Apr
25-Apr
16-May06-Jun27-Jun0**See Annex 1: Data, table, and figure notes
1

Deaths

25 000 000

At the country level, the highest numbers of new weekly cases were reported from France (603 074 new cases; +33%),
Germany (555 331 new cases; -2%), Italy (511 037 new cases; +50%), the United States of America (496 049 newcases; -29%), and Brazil (334 852 new cases; -4%).
The highest numbers of new weekly deaths were reported from the United States of America (1 622 new deaths;-19%), Brazil (1 187 new deaths; -10%), China (755 new deaths; -30%), Italy (430 new deaths; +21%), and the RussianFederation (371 new deaths; -14%).

Table 1. Newly reported and cumulative COVID-19 confirmed cases and deaths, by WHO Region, as of 3 July 2022**
New cases inlast 7 days(%)

Change in newcases in last 7days *

Cumulative
cases (%)

New deaths inlast 7 days (%)

Change in new
deaths in last 7days *

Cumulative
deaths (%)

Europe2 421 772
(52%)

15%

228 917 538
(42%)

2 347
(29%)

-12%

2 027 968
(32%)

Americas1 128 639
(24%)

-18%

163 205 242
(30%)

3 632
(45%)

-13%

2 762 527
(44%)

Western Pacific827 117(18%)

4%64 433 670
(12%)

1 526
(19%)

-12%

238 904(4%)

South-East Asia

157 080(3%)

20%

58 628 247
(11%)

364
(4%)

16%

790 178(12%)

Eastern
Mediterranean

95 912(2%)

29%

22 044 303
(4%)

111
(1%)

34%

343 596(5%)

Africa18 483(0%)-33%

9 134 221
(2%)

122
(2%)

-50%

173 616(3%)

Global

4 649 003
(100%)

3%

546 363 985(100%)

8 102(100%)-12%

6 336 802
(100%)WHO Region*Percent change in the number of newly confirmed cases/deaths in the past seven days, compared to seven days prior**See Annex 1: Data, table, and figure notes

For the latest data and other updates on COVID-19, please see:• WHO COVID-19 Dashboard• WHO COVID-19 Weekly Operational Update and previous editions of the Weekly Epidemiological Update
WHO COVID-19 detailed surveillance data dashboard

2

Figure 2. COVID-19 cases per 100 000 population reported by countries, territories and areas, 27 June - 3 July 2022***See Annex 1: Data, table, and figure notes3Figure 3. COVID-19 deaths per 100 000 population reported by countries, territories and areas, 27 June - 3 July 2022****See Annex 1: Data, table, and figure notes
4Special Focus: Update on SARS-CoV-2 variants of interest and variants of concern
WHO, in collaboration with national authorities, institutions and researchers, routinely assesses if variants of SARSCoV-2 alter transmission or disease characteristics, or impact the effectiveness of vaccines, therapeutics, diagnostics
or public health and social measures (PHSM) applied to control disease spread. Potential variants of concern (VOCs),variants of interest (VOIs) or variants under monitoring (VUMs) are regularly assessed based on the risk posed to
global public health.
The classifications of variants will be revised as needed to reflect the continuous evolution of circulating variants andtheir changing epidemiology. Criteria for variant classification, and the lists of currently circulating and previously
circulating VOCs, VOIs and VUMs, are available on the WHO Tracking SARS-CoV-2 variants website. National
authorities may choose to designate other variants and are strongly encouraged to investigate and report newly
emerging variants and their impact.1
Geographic spread and prevalence of VOCs
The Omicron VOC continues to be the dominant variant circulating globally, accounting for 92% of sequences
reported to GISAID between 1 and 30 June 2022. The remaining 8% waiting to be assigned are (presumed Omicron),
Delta VOC and recombinants. Among Omicron lineages, the proportions of BA.5 and BA.4 continue to increase. BA.5
has been detected in 83 countries, and during epidemiological week 25 (19 to 25 June), the proportion of BA.5 among
all sequences submitted weekly to GISAID increased from 37% to 52% (Table 2). Although BA.4 is also rising globally,
the rate of increase is not as high as that of BA.5. BA.4 has been detected in 73 countries, and now accounts for 12%of all sequences submitted during week 25 (up from 11% in the previous week). BA.4 and BA.5 share similar
mutations in SARS-CoV-2 spike but have different mutations in non-spike regions.
Globally, the proportions of Omicron lineages BA.2 and BA.2.12.1 have decreased as compared to week 23 (5 to 11June). During week 25, the prevalence of BA.2 among all sequences submitted to GISAID was 9% (a decrease from
16% in the previous week) and the prevalence of BA.2.12.1 was 11% (a decrease from 19% in the previous week).
BA.2 and BA.2.12.1 have been reported in 150 and 84 countries, respectively. There is no evidence yet regarding any
change in severity with BA.4, BA.5 or BA.2.12.1 as compared to BA.2. However, the rise in prevalence of BA.2.12.1,
BA.4 and BA.5 has coincided with an increase in cases in several WHO regions. In some countries, the rise in cases
also resulted in a surge in hospitalizations, ICU admissions and deaths. In countries where the incidence of BA.4, BA.5
or BA.2.12.1 cases is now declining, the rise in cases, hospitalizations, ICU admissions and deaths have been lower ascompared to the previous BA.1 and/or BA.2 waves. The differences observed in epidemiological situations is likely
influenced by a number of factors, including surveillance, vaccination coverage and the implementation of PHSM.

5

Figure 4. Panel A and B: The number and percentage of SARS-CoV-2 sequences, as of 3 July 2022

Figure 4 Panel A shows the number and Panel B the percentage of all circulating variants since 1 April 2022. Omicron sister-lineages and additional
Omicron VOC descendent lineages under further monitoring (VOC-VUM) are shown. BA.1.X and BA.2.X include all BA.1 and BA.2 pooled descendent
lineages, except those already shown in the figure above. Source: SARS-CoV-2 sequence data and metadata from GISAID, as of 3 July 2022.

6

Table 2. Relative proportions of SARS-CoV-2 sequences over the last four weeks by specimen collection date

Lineage
BA.1
BA.1.1BA.1.X*
BA.2
BA.2.11BA.2.12.1
BA.2.13BA.2.9.1
BA.2.X*
BA.3
BA.4
BA.5
Delta#
Other^Countries
177
177
176
150
20
84
44
14
137
41
73
83
202
210

Sequencesa
494 370973 139907 266
1 140 152697
180 1773 366
722
508 704
1 060
23 62556 476
4 348 347
2 706 558

2022-22
0.04
0.12
0.08
27.17
0.03
32.93
0.52
0.02
13.51
0.01
5.68
14.22
0.02
5.65

2022-23
0.03
0.06
0.03
21.06
0.02
29.76
0.47
0.02
10.00
0.02
8.35
23.11
0.00
7.08

Last 4 weeks by collection date (%) b2022-242022-25
0.01
0.00
0.03
0.03
0.04
0.02
15.89
9.00
0.01
0.06
19.03
10.57
0.38
0.41
0.01
0.00
7.47
4.41
0.03
0.00
10.69
12.48
36.92
51.68
0.01
0.01
9.48
11.34

a Data source: cumulative sequences and metadata from GISAID.
b Relative proportions in %.

*BA.1.X and BA.2.X include all BA.1 and BA.2 pooled descendent lineages, except those already shown in the table.
# Previously circulating VOC.
^
Other include sequences waiting to be assigned, Delta VOC and recombinants.

Characteristics of Omicron
Available evidence on the phenotypic impacts of VOCs is reported in previous editions of the COVID-19 Weekly Epidemiological Update. Table 2
summarizes the phenotypic characteristics of the Omicron VOC and its sub-lineages for which evidence is available since the last update on 22 June 2022.
Some of these studies have not been peer-reviewed and the findings must, therefore, be interpreted with due consideration of this limitation.
1

Table 3. Summary of phenotypic characteristics* of the Omicron VOC
Public healthdomain of impact
Transmissibility

Disease severity

Risk ofreinfection

Impact on
antibody
responses
Impacts on
diagnostics

Impact on
treatment
Impact on
vaccination

1

Omicron sublineages

Omicron (B.1.1.529)
BA.1
Growth advantage and increased transmissibility compared to
Delta

1

Lower transmissibility
compared to BA.22

Overall evidence suggests lower severity despite some conflicting
results. Earlier studies reported lower severity compared to Delta.
3–7 However, more recent studies in different settings reported
similar 8,9 or increased severity10 compared to Delta.3–7,11 12No
differenceindiseaseseverity
compared to BA.213

Reduced risk of Omicron reinfection among individuals previously
infected with a different SARS-CoV-2 variant compared to naïve
individuals17,18

Reduced risk ofreinfection with BA.1
following infection
with BA.219

Reduction in neutralizing activity as compared to other VOCs20–22

Lower neutralising
antibody titers
compared to the index
virus 21

BA.2
Increasedtransmissibility
compared to BA.1 2
No difference indisease severity
compared to BA.113
Reduced risk ofreinfection with
BA.2 following
infection with BA.1

BA.4

BA.5

Growth advantage
compared to BA.2 2

Growth advantage over
BA.22

Currently available
evidence does notsuggest a difference indisease severity
compared to BA.1 14

Currently available
evidence does not suggest
a difference in disease
severity compared to BA.1
15,16

No specific data
available

No specific data available

Lower neutralising
antibody titres (7.6-fold)compared to BA.1 23–25

Lower neutralising antibody
titres (7.5-fold) compared toBA.1 23,25

19

Lower neutralising
antibody titers
compared to theindex virus21

PCR assays that include multiple gene targets maintain their
The majority will be
accuracy to detect Omicron26; S gene target failure/positivity
S gene target failure.
S gene target failure.
S gene target failure.
S gene target(SGTF) may be a proxy for screening. Limited to no impact on
positive (SGTP).
sensitivity of Ag-RDTs observed27–30
No difference in the effectiveness of antiviral agents (polymerase
Reduced
Reduced efficacy of
Reduced neutralising
Reduced neutralisingand protease inhibitors) against the Omicron variant31. Conserved
neutralising activity
38,
cilgavimab36 andactivityofcilgavimab
activity of cilgavimab38,
neutralizing activity for three broadly neutralizing monoclonalof sotrovimab36, 37 ,casirivimab-imdevimab
casirivimab andcasirivimab andantibodies (sotrovimab, S2X259 and S2H97) and a reduced
casirivimab and37
38
imdevimab
imdevimab38
effectiveness of other monoclonal antibodies32–35
imdevimab 38
Results of vaccine effectiveness (VE) studies should be interpreted with caution because estimates vary with the type of vaccine administered and the number of doses andscheduling (sequential administration of different vaccines). For further information, see the section Interpretation of the results of the VE for the Omicron variant.

Similar methodology used as Reference 1

2

Figure 5. Vaccine effectiveness (VE) of primary series and first booster vaccination against the Omicron variant of concern

Dots represent point estimates of VE from each study; dark black horizontal lines represent median VE across all studies in stratum. All data is from a systematic review of COVID-19 VE studies; methods and summary
tables of VE studies can be found on view-hub.org. Vertical panels represent VE for full primary series (grey dots) and VE for homologous or heterologous booster vaccination (other colored dots) following completion ofprimary series vaccination with vaccine of primary series noted in panel header. All booster VE estimates are for the first booster dose. Severe disease includes hospitalization and pneumonia; symptomatic disease includes
disease of any severity level; any infection can include symptomatic and asymptomatic infection. Additional details on the methods for inclusion of the estimates in the plots provided in text.

3

Figure 5 summarizes the impact of the Omicron variant on vaccine effectiveness (VE) over time, grouped by the primaryseries vaccine; booster doses may have been a different vaccine (i.e., both homologous and heterologous booster
vaccination VEs are shown). Additional information on vaccine performance against VOCs can also be found in Annex 2.

Methods for Figure 5
•
•

•

•

VE studies included in the plot were identified from an ongoing systematic review of COVID-19 vaccine effectivenessstudies. All studies were cohort or test-negative designs conducted when Omicron was the predominant circulating
variant. Methods for the systematic review and inclusion/exclusion criteria are available on view-hub.org.
Only studies providing VE estimates of individual vaccines are included in the plot; studies assessing combined VE ofmore than one vaccine are excluded except for studies of heterologous primary and booster schedules where allparticipants included in a VE estimate received the same brands of vaccines in the same order.
Only studies providing VE estimates for discrete time intervals since vaccination or estimates with limited follow-up
time (such that the median time point falls clearly in one of the intervals for the plot) are included. Studies that only
provide VE estimates over a cumulative period of time covering more than one time interval are excluded because
they are difficult to interpret due to the marked waning of VE over time with Omicron.
Only estimates of absolute vaccine effectiveness (i.e., the comparison group is unvaccinated persons) are included in
the plot; estimates of relative vaccine effectiveness (e.g., the comparison group is persons having completed theprimary series) are excluded as the interpretation of relative vaccine effectiveness is not comparable with absolute
vaccine effectiveness.

Interpretation of the results of absolute VE for the Omicron variant
To date, 33 studies from 14 countries (Argentina, Brazil, Canada, Chile, Czech Republic, Denmark, Finland, Norway,
Israel, Qatar, South Africa, the United Kingdom, the United States of America, and Zambia) have collectively assessed
the protection of six vaccines against the Omicron variant (12 studies contributed VE estimates of primary series
vaccination only, four contributed to estimates of first booster vaccination only, and 17 contributed to both). Findings
from these studies show reduced VE of COVID-19 primary series vaccines against the Omicron variant for all
outcomes (severe disease, symptomatic disease, and infection) than has been observed for the other four VOCs.
Importantly though, VE estimates against the Omicron variant remain higher for severe disease than the otheroutcomes, in the majority of studies. The first booster vaccination substantially improves VE for all outcomes and for
all combinations of schedules with estimates available for both primary series and booster vaccination. VE declines
more over time after the first booster vaccination for symptomatic disease and infection than it does for severe
disease39; however, studies that assess VE of booster vaccination beyond six months to evaluate longer duration ofprotection are not yet available.
For severe disease, VE of the primary series showed little decline over six months. VE was ≥70% during the first threemonths after primary series vaccination for seven of 13 (54%) VE estimates for the mRNA vaccines (ModernaSpikevax and Pfizer BioNTech-Comirnaty). Of the two vector vaccines studies available, both had VE <70%: one
reported VE <70% for AstraZeneca-Vaxzevria and the other reported VE <50% for Janssen-Ad26.COV2.S. Four
estimates were available for inactivated vaccines: none of the three estimates for Sinovac-CoronaVac were ≥ 70% (2[67%] were ≥ 50%); the single estimate for Beijing CNBG-BBIBP-CorV was <70% but ≥50%. Beyond three months after1

vaccination, VE was ≥70% for 14 of 29 (48%) VE estimates for the mRNA vaccines (20 [69%] had VE ≥50%); one of 13(8%) AstraZeneca-Vaxzevria VE estimates was ≥70% (9 [69%] were ≥50%); neither of the two estimates for the othervector-based vaccine, Janssen-Ad26.COV2.S, was ≥50%; the two VE estimates for Sinovac-CoronaVac were ≥50% but<70%.
The first booster dose vaccination improved VE against severe disease in all studies, and VE was ≥70% in 34 (94%) of
36 estimates evaluating VE between 14 days and three months of receipt of a booster dose (33 estimates evaluatedan mRNA booster, two evaluated a Janssen-Ad26.COV2.S booster, and one evaluated a Sinovac-CoronaVac booster);one Moderna-Spikevax booster dose had VE <50%, and one Janssen-Ad26.COV2.S booster dose had VE <70%. At
three to six months post mRNA booster, VE was ≥70% for 21 of 26 (81%) estimates (the primary series was an mRNA
vaccine in 17 of the 26 estimates, AstraZeneca-Vaxzevria in eight and Sinovac-CoronaVac in one). One study foundthe VE to be <70% but ≥50% following three to six months from the third dose of Sinovac-CoronaVac.
VE against symptomatic disease and infection within the first three months of primary series vaccination was lower
than against severe disease, and VE decreased more substantially over time. For symptomatic disease, only three of
14 (21%) VE estimates for the mRNA vaccines were ≥70% and only seven (50%) were ≥50%; one (25%) of the four VE
estimates for AstraZeneca-Vaxzevria was ≥70% while the remaining three estimates were <50%; the single estimate
for Janssen-Ad26.COV2.S was ≥70%, and both estimates for Sinovac (CoronaVac) were <50%. Beyond three months
after vaccination, there were 31 VE estimates (21 estimates evaluated mRNA vaccines, eight evaluated AstraZenecaVaxzevria, and two evaluated Sinovac-CoronaVac), of which only one was ≥50% . mRNA booster vaccination after
completion of a primary series of an mRNA vaccine, AstraZeneca-Vaxzevria, or Sinovac-CoronaVac improved VE
against symptomatic disease: five of 21 (24%) VE estimates between 14 days and three months post booster were≥70% (16 [76%] were ≥50%); one (50%) of two VE estimates evaluating three doses of AstraZeneca-Vaxzevria was≥50% but <70% as was the single estimate for three doses of Janssen-Ad26.COV2.S, and the single estimate for threedoses of Sinovac-CoronaVac was <50%. However, first booster dose protection declined rapidly over time: only threeof 13 (23%) estimates available at three to six months following receipt of an mRNA booster dose had VE ≥50% andnone were ≥70%. Neither the single estimate for three doses of AstraZeneca-Vaxzevria nor the single estimate forthree doses of Sinovac-CoronaVac assessed three to six months post booster vaccination was above 50%. VE against
infection showed a similar pattern of waning as that against symptomatic disease.

2WHO regional overviews:

Region of the Americas

Epidemiological week 27 June - 3 July 2022**

African Region

The Region of the Americas reported a decrease in the number of new weekly
cases, with over 1.1 million new cases reported, an 18% decrease ascompared to the previous week. Fourteen of 46 (30%) countries for whichdata are available reported increases in the number of new cases of 20% or
greater, with some of the greatest proportional increases observed in Saint
Kitts and Nevis (155 vs 37 new cases; +319%), Haiti (302 vs 75 new cases;+303%), and Saint Barthélemy (43 vs 26 new cases; +65%). The highest
numbers of new cases were reported from the United States of America (496049 new cases; 149.9 new cases per 100 000; -29%), Brazil (334 852 newcases; 157.5 new cases per 100 000; -4%), and Mexico (97 374 new cases;
75.5 new cases per 100 000; +27%).

The African Region reported a decline in the number of new weekly cases,
with over 18 000 new cases reported, a 33% decrease as compared to theprevious week. Thirteen (25%) countries reported an increase in the numberof new cases of 20% or greater, with some of the greatest proportional
increases seen in Mauritania (699 vs 135 new cases; +418%), Equatorial
Guinea (92 vs 44 new cases; +109%) and Côte d’Ivoire (638 vs 340 new cases;+88%). The countries that reported the highest numbers of new cases wereSouth Africa (2842 new cases; 4.8 new cases per 100 000 population; -58%),
Kenya (2283 new cases; 4.2 new cases per 100 000; -20%), and Ethiopia (2038
new cases; 1.8 new cases per 100 000; -41%).

The number of new weekly deaths in the Region decreased by 13% ascompared to the previous week, with over 3600 new deaths reported. The
highest numbers of new deaths were reported from the United States ofAmerica (1622 new deaths; <1 new death per 100 000; -19%), Brazil (1187
new deaths; <1 new deaths per 100 000; -10%), and Chile (178 new deaths;<1 new death per 100 000; +12%).

African Region

6 000
5 000

250 000

4 000

200 000

Cases

Deaths3 000

150 000

2 000

100 000

1 000

50 000006-Jan27-Jan17-Feb
09-Mar30-Mar20-Apr
11-May01-Jun22-Jun13-Jul03-Aug24-Aug
14-Sep05-Oct26-Oct16-Nov
07-Dec28-Dec18-Jan08-Feb01-Mar22-Mar
12-Apr03-May24-May14-Jun05-Jul
26-Jul16-Aug06-Sep27-Sep18-Oct08-Nov
29-Nov
20-Dec10-Jan31-Jan21-Feb
14-Mar
04-Apr
25-Apr
16-May06-Jun27-Jun0

Cases
DeathsRegion of the Americas

50 00040 00030 000
20 000
10 0000

Reported week commencing

Reported week commencing

Updates from the Region of the Americas

Updates from the African Region
3

60 000Deaths300 000

Cases
DeathsCases

350 000

9 000 000
8 000 000
7 000 000
6 000 000
5 000 000
4 000 000
3 000 000
2 000 000
1 000 000
006-Jan27-Jan17-Feb
09-Mar30-Mar20-Apr
11-May01-Jun22-Jun13-Jul03-Aug24-Aug
14-Sep05-Oct26-Oct16-Nov
07-Dec28-Dec18-Jan08-Feb01-Mar22-Mar
12-Apr03-May24-May14-Jun05-Jul
26-Jul16-Aug06-Sep27-Sep18-Oct08-Nov
29-Nov
20-Dec10-Jan31-Jan21-Feb
14-Mar
04-Apr
25-Apr
16-May06-Jun27-Jun

The number of new weekly deaths in the Region decreased by 50% ascompared to the previous week, with over 100 new deaths reported. The
highest numbers of new deaths were reported from South Africa (81 newdeaths; <1 new death per 100 000 population; -39%), Zimbabwe (nine new
deaths; <1 new death per 100 000; -40%), and Ethiopia (eight new deaths; <1
new death per 100 000; similar to the previous week’s figures).

Eastern Mediterranean Region

European Region

The Eastern Mediterranean Region reported just under 96 000 new weekly
cases, representing a 29% increase as compared to the previous week. Eight(36%) countries reported increases in the number of new cases of 20% or
greater, with the greatest proportional increases observed in the occupied
Palestinian territory (1350 vs 403 new cases; +235%), Iraq (15 791 vs 6237
new cases; +153%), and Tunisia (5477 vs 2277 new cases; +141%). The highest
numbers of new cases were reported from Morocco (21 124 new cases; 57.2
new cases per 100 000; +19%), Iraq (15 791 new cases; 39.3 new cases per
100 000; +153%), and the United Arab Emirates (12 347 new cases; 124.8 newcases per 100 000; +11%).

New weekly cases have continued to increase for over a month in theEuropean Region, with over 2.4 million new cases reported, a 15%
increase compared to the previous week. Thirty-one (51%) countries in
the Region reported increases in new cases of 20% or greater, with thegreatest proportional increases observed in Kosovo[1] (849 vs 199 newcases; +327%), Kyrgyzstan (29 vs 7 new cases; +314%) and Kazakhstan(959 vs 299 new cases; +221%). The highest numbers of new cases werereported from France (603 074 new cases; 927.2 new cases per 100 000;+33%), Germany (555 331 new cases; 667.7 new cases per 100 000; -2%),and Italy (511 037 new cases; 856.8 new cases per 100 000; +50%).

The number of new weekly deaths in the Region increased by 34% ascompared to the previous week, with over 100 new deaths reported. Someof the highest numbers of new deaths were reported from Tunisia (21 newdeaths; <1 new death per 100 000; +40%), Morocco (18 new deaths; <1 newdeath per 100 000; +50%), and Saudi Arabia (13 new deaths; <1 new deathper 100 000; similar to the previous week’s figures).
9 000

700 000

7 000

12 000 000

600 000

6 000

500 000

5 000

400 000

4 000

300 000

3 000

200 000

2 000

4 000 000

100 000

1 000

2 000 000

006-Jan27-Jan17-Feb
09-Mar30-Mar20-Apr
11-May01-Jun22-Jun13-Jul03-Aug24-Aug
14-Sep05-Oct26-Oct16-Nov
07-Dec28-Dec18-Jan08-Feb01-Mar22-Mar
12-Apr03-May24-May14-Jun05-Jul
26-Jul16-Aug06-Sep27-Sep18-Oct08-Nov
29-Nov
20-Dec10-Jan31-Jan21-Feb
14-Mar
04-Apr
25-Apr
16-May06-Jun27-Jun

14 000 000

Cases

European Region

40 000Deaths35 00030 0008 000 000

25 0006 000 000

20 000Cases

Deaths

10 000 000

00Reported week commencing

15 000
10 000
5 000

Reported week commencing

Updates from the Eastern Mediterranean Region

Updates from the European Region
445 0000DeathsEastern Mediterranean Region

8 000

800 000

Cases

Cases
Deaths06-Jan27-Jan17-Feb
09-Mar30-Mar20-Apr
11-May01-Jun22-Jun13-Jul03-Aug24-Aug
14-Sep05-Oct26-Oct16-Nov
07-Dec28-Dec18-Jan08-Feb01-Mar22-Mar
12-Apr03-May24-May14-Jun05-Jul
26-Jul16-Aug06-Sep27-Sep18-Oct08-Nov
29-Nov
20-Dec10-Jan31-Jan21-Feb
14-Mar
04-Apr
25-Apr
16-May06-Jun27-Jun900 000

Over 2300 new weekly deaths were reported in the Region, a 12%
decrease as compared to the previous week. The highest numbers of new
deaths were reported from Italy (430 new deaths; <1 new death per
100 000; +21%), the Russian Federation (371 new deaths; <1 new deathper 100 000; -14%), and Spain (312 new deaths; <1 new death per 100000; -2%).

South-East Asia Region

Western Pacific Region

The South-East Asia Region has been reporting an increasing trend incases since early June, with over 157 000 new cases reported, a 20%
increase as compared to the previous week. Five of 10 countries (50%) for
which data are available showed increases in the number of new cases of
20% or greater, with the greatest proportional increases observed in
Bhutan (103 vs 48 new cases; +115%), Nepal (268 vs 171 new cases; +57%)
and Bangladesh (13516 vs 8846 new cases; +53%). The highest numbersof new cases were reported from India (112 456 new cases; 8.1 new cases
per 100 000; +21%), Thailand (15 950 new cases; 22.9 new cases per 100000; +6%), and Bangladesh (13 516 new cases; 8.2 new cases per 100 000;+53%).

After a decreasing trend in cases since mid-May, the Western PacificRegion reported a slight increase in new weekly cases, with over 827 000
new cases, a 4% increase as compared to the previous week. Thirteen(39%) countries reported increases in new cases of 20% or greater, withsome of the largest proportional increases observed in the
Commonwealth of the Northern Mariana Islands (190 vs 87 new cases;+118%), Palau (36 vs 20 new cases; +80%) and New Caledonia (822 vs 513
new cases; +60%). The highest numbers of new cases were reported from
China (270 446 new cases; 18.4 new cases per 100 000; -19%), Australia (210389 new cases; 825.1 new cases per 100 000; +7%), and Japan (136 357 newcases; 107.8 new cases per 100 000; +25% ).

The number of new weekly deaths in the Region increased by 16% ascompared to the previous week, with over 350 new deaths reported. The
highest numbers of new deaths were reported from India (200 new deaths;<1 new death per 100 000; +39%), Thailand (108 new deaths; <1 new deathper 100 000; -14%), and Indonesia (32 new deaths; <1 new death per 100 000;
+7%).

The Region reported over 1500 new weekly deaths, representing a 12%
decrease as compared to the previous week. The highest numbers of new
deaths were reported from China (755 new deaths; <1 new death per 100000; -30%), Australia (331 new deaths; 1.3 new death per 100 000; similar
to the previous week’s figures), and Japan (192 new deaths; <1 new deathper 100 000; +106%).

South-East Asia Region

2 000 000

20 0001 500 000

15 0001 000 000

10 000500 000

5 000

006-Jan27-Jan17-Feb
09-Mar30-Mar20-Apr
11-May01-Jun22-Jun13-Jul03-Aug24-Aug
14-Sep05-Oct26-Oct16-Nov
07-Dec28-Dec18-Jan08-Feb01-Mar22-Mar
12-Apr03-May24-May14-Jun05-Jul
26-Jul16-Aug06-Sep27-Sep18-Oct08-Nov
29-Nov
20-Dec10-Jan31-Jan21-Feb
14-Mar
04-Apr
25-Apr
16-May06-Jun27-JunCases

25 000

6 000
5 000

4 000 000

4 000
3 000 000

3 000

2 000 000

2 000

1 000 000
0

0

1 000

Reported week commencing

Reported week commencing

Updates from the Western Pacific Region

Updates from the South-East Asia Region
5

8 000
7 000

5 000 000

30 0002 500 000

Western Pacific Region

06-Jan27-Jan17-Feb
09-Mar30-Mar20-Apr
11-May01-Jun22-Jun13-Jul03-Aug24-Aug
14-Sep05-Oct26-Oct16-Nov
07-Dec28-Dec18-Jan08-Feb01-Mar22-Mar
12-Apr03-May24-May14-Jun05-Jul
26-Jul16-Aug06-Sep27-Sep18-Oct08-Nov
29-Nov
20-Dec10-Jan31-Jan21-Feb
14-Mar
04-Apr
25-Apr
16-May06-Jun27-JunCases
DeathsCases

3 000 000

6 000 000

35 000Deaths3 500 000

Cases
Deaths0

Deaths7 000 000

Annex 1. Data, table, and figure notes
Data presented are based on official laboratory-confirmed COVID-19 cases and deaths reported to WHO by
country/territories/areas, largely based upon WHO case definitions and surveillance guidance. While steps are taken to ensure
accuracy and reliability, all data are subject to continuous verification and change, and caution must be taken when interpretingthese data as several factors influence the counts presented, with variable underestimation of true case and death incidences,and variable delays to reflecting these data at the global level. Case detection, inclusion criteria, testing strategies, reporting
practices, and data cut-off and lag times differ between countries/territories/areas. A small number ofcountries/territories/areas report combined probable and laboratory-confirmed cases. Differences are to be expected between
information products published by WHO, national public health authorities, and other sources.
Due to public health authorities conducting data reconciliation exercises that remove large numbers of cases or deaths fromtheir total counts, negative numbers may be displayed in the new cases/deaths columns as appropriate. When additional details
become available that allow the subtractions to be suitably apportioned to previous days, graphics will be updated accordingly.
A record of historic data adjustment made is available upon request by emailing epi-data-support@who.int. Please specify thecountries of interest, time period, and purpose of the request/intended usage. Prior situation reports will not be edited; see
covid19.who.int for the most up-to-date data. COVID-19 confirmed cases and deaths reported in the last seven days bycountries, territories, and areas, and WHO Region (reported in previous issues) are now available at:https://covid19.who.int/table.
‘Countries’ may refer to countries, territories, areas or other jurisdictions of similar status. The designations employed, and thepresentation of these materials do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal
status of any country, territory, or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dottedand dashed lines on maps represent approximate border lines for which there may not yet be full agreement. Countries,
territories, and areas are arranged under the administering WHO region. The mention of specific companies or of certain
manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar
nature that are not mentioned. Errors and omissions except, the names of proprietary products are distinguished by initial
capital letters.
[1]

All references to Kosovo should be understood to be in the context of the United Nations Security Council resolution 1244
(1999). In the map, the number of cases of Serbia and Kosovo (UNSCR 1244, 1999) have been aggregated for visualization
purposes.
[2]
Since 21 May 2022, data for COVID-19 cases and deaths in Northern Ireland was no longer included in the United Kingdom
updates.
[3]
Updates of an outbreak of COVID-19 reported in the Democratic People’s Republic of Korea continue through official media
since 12 May 2022; however, at present, no confirmed cases or deaths have been reported to WHO.

6

Annex 2. Neutralization Studies of Primary Series and First Booster Vaccine Performance against Omicron Variant of Concern (data as of 27 June 2022)
Omicron Sub-Lineage
BA.1

BA.2

BA.2.12.1

BA.3

BA.4/BA.5

AstraZeneca-Vaxzevria/SII-Covishield

HNR9

HNR1

----

----

----

Beijing CNBG-BBIBP-CorV

HNR7

HNR2

----

HNR1

HNR1

Bharat-Covaxin

↓↓1

----

----

----

----

Cansino-Covidecia

----

----

----

----

----

Primary Series Vaccination

WHO Emergency
Use Listing (EUL)
Qualified Vaccines

Vaccines without
WHO EUL

Janssen-Ad26-COV2.S

HNR6

----

----

----

----

Moderna-Spikevax

↓↓↓10

HNR2

↓↓↓1

----

----

Novavax-Nuvaxovid/SII - Covavax

----

----

----

----

----

Pfizer BioNTech-Comirnaty

HNR47

↓↓↓2

↓↓↓2

HNR1

HNR1

Sinovac-CoronaVac

↓↓↓1
----

-------

----

----

----

Anhui ZL-Recombinant

----

----

----

Gamaleya-Sputnik V

HNR2

----

----

----

----

HNR2

HNR2

----

----

----

Booster Vaccination (Primary Series Vaccine + Booster Vaccine)
AstraZeneca-Vaxzevria/SII-Covishield + AstraZeneca-Vaxzevria/SII Covishield

WHO Emergency
Use Listing (EUL)
Qualified Booster
Vaccines

Booster Vaccines
without WHO EUL

AstraZeneca-Vaxzevria/SII-Covishield + Moderna-Spikevax

↓1

----

----

----

----

AstraZeneca-Vaxzevria/SII-Covishield + Pfizer BioNTech-Comirnaty

↓↓1

↓↓1

----

↓↓1

----

Beijing CNBG-BBIBP-CorV + Beijing CNBG-BBIBP-CorV↓↓to↓↓↓6

HNR2

HNR1

↓↓1

HNR1

Janssen-Ad26-COV2.S + Janssen-Ad26-COV2.S
Moderna-Spikevax + Moderna-Spikevax

HNR1↓to↓↓↓9---↓↓1---↓↓1↓↓1-------↓↓↓1

----

----

↓to↓↓↓38↓to↓↓↓11↓↓↓1↓to↓↓↓3↓↓to↓↓↓3

Pfizer BioNTech-Comirnaty + Janssen-Ad26-COV2.S

↓2

----

----

----

----

Pfizer BioNTech-Comirnaty + Moderna-Spikevax↓to↓↓2

----

----

----

----

Sinovac-CoronaVac + Sinovac-CoronaVac

HNR6

↓↓2

↓↓1

↓↓1

↓↓1

Sinovac-CoronaVac + Pfizer BioNTech-Comirnaty

↓↓2

↓↓1

----

----

----

Anhui ZL-Recombinant + Anhui ZL-RecombinantBeijing CNBG-BBIBP-CorV + Anhui ZL - Recombinant

HNR3↓↓to↓↓↓5---HNR2---HNR1---↓↓↓1---HNR1

Gamaleya-Sputnik V + Gamaleya Sputnik Light

↓↓1

----

----

----

----

Sinovac-CoronaVac + Anhui ZL - Recombinant

↓1

↓1

↓1

↓1

↓↓1

Moderna-Spikevax + Pfizer BioNTech-Comirnaty↓↓↓1

Pfizer BioNTech-Comirnaty + Pfizer BioNTech-Comirnaty

Abbreviations: HNR=high non-response. Arrows generalize the magnitude of reduction in neutralization against the Omicron sub-lineage relative to the ancestral strain: “↔” indicates <2-fold reduction in neutralization; “↓”indicates 2 to <5-fold reduction; “↓↓” indicates 5 to <10-fold reduction; “↓↓↓” indicates ≥10-fold reduction. When more than one neutralization study is available, the interquartile range (25th and 75th percentiles) of foldreductions across all studies was used, restricting to studies reporting ≥75% of persons/sera with detectable neutralization titers. HNR indicates a median percent of persons/sera with detectable neutralization titers across allstudies of <75%; in these instances, fold-reductions can be biased and, thus are not presented. The number of studies is shown as subscripts. For booster vaccination, only schedules with available results are shown.

7

Additional notes on Annex 2 table•

Studies contributing to the table are identified from an ongoing review of the preprint and published literature on
neutralization of SARS-CoV-2 variants by COVID-19 vaccines.

•

Studies that use samples collected more than seven days and less than six months after complete vaccination and that usean ancestral strain as the reference are included in the table.

•

Studies of immunocompromised persons are excluded.

•

It is important to note that studies vary in population and other methodological considerations, which may in part explainsome differences when comparing products between different studies. In addition, the reductions summarized in the table
do not incorporate uncertainty intervals around the degree of reductions, which can vary substantially across studies whenreported.

8

References1.

Campbell F, Archer B, Laurenson-Schafer H, et al. Increased transmissibility and global spread of SARS-CoV-2
variants of concern as at June 2021. Eurosurveillance. 2021;26(24):2100509.

2.

UK Health Security Agency. SARS-CoV-2 variants of concern and variants under investigation in England. Technicalbriefing 43. 24 June 2022.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1086494/Tec
hnical-Briefing-43-28.06.22.pdf

3.

Ferguson N, Ghani A, Hinsley W, Volz E. Report 50: Hospitalisation Risk for Omicron Cases in England. Imperial
College London; 2021. Accessed December 23, 2021. https://www.imperial.ac.uk/media/imperialcollege/medicine/mrc-gida/2021-12-22-COVID19-Report-50.pdf

4.

Ulloa AC, Buchan SA, Daneman N, Brown KA. Estimates of SARS-CoV-2 Omicron Variant Severity in Ontario,
Canada. JAMA. Published online February 17, 2022. doi:10.1001/jama.2022.2274

5.

Lewnard JA, Hong VX, Patel MM, Kahn R, Lipsitch M, Tartof SY. Clinical Outcomes among Patients Infected with
Omicron (B.1.1.529) SARS-CoV-2 Variant in Southern California. Epidemiology; 2022.
doi:10.1101/2022.01.11.22269045

6.

Nyberg T, Twohig KA, Harris RJ, et al. Risk of hospital admission for patients with SARS-CoV-2 variant B.1.1.7:
cohort analysis. BMJ. 2021;373:n1412. doi:10.1136/bmj.n1412

7.

Wolter N, Jassat W, Walaza S, et al. Early Assessment of the Clinical Severity of the SARS-CoV-2 Omicron Variant inSouth Africa. Infectious Diseases (except HIV/AIDS); 2021. doi:10.1101/2021.12.21.21268116

8.

Gunadi, Hakim MS, Wibawa H, et al. Comparative Analysis of the Outcomes of COVID-19 between Patients Infectedwith SARS-CoV-2 Omicron and Delta Variants: A Retrospective Cohort Study. Public and Global Health; 2022.
doi:10.1101/2022.04.30.22274532

9.

Strasser Z, Hadavand A, Murphy S, Estiri H. SARS-CoV-2 Omicron Variant Is as Deadly as Previous Waves After
Adjusting for Vaccinations, Demographics, and Comorbidities. In Review; 2022. doi:10.21203/rs.3.rs-1601788/v1

10.

Grint DJ, Wing K, Gibbs HP, et al. Accident and Emergency (AE) Attendance in England Following Infection with
SARS-CoV-2 Omicron or Delta. Infectious Diseases (except HIV/AIDS); 2022. doi:10.1101/2022.05.03.22274602

11.

Wang Z, Schmidt F, Weisblum Y, et al. mRNA vaccine-elicited antibodies to SARS-CoV-2 and circulating variants.
Nature. Published online February 2021. https://www.ncbi.nlm.nih.gov/pubmed/33567448

12.

Nyberg T, Ferguson NM, Nash SG, et al. Comparative analysis of the risks of hospitalisation and death associatedwith SARS-CoV-2 omicron (B.1.1.529) and delta (B.1.617.2) variants in England: a cohort study. The Lancet.
2022;399(10332):1303-1312. doi:10.1016/S0140-6736(22)00462-7

13.

Wolter N, Jassat W, DATCOV-Gen author group, von Gottberg A, Cohen C. Clinical Severity of Omicron Sub-Lineage
BA.2 Compared to BA.1 in South Africa. Infectious Diseases (except HIV/AIDS); 2022.
doi:10.1101/2022.02.17.22271030

14.

COVID-19 Hospital Surveillance ; Update: Week 23, 2022. https://www.nicd.ac.za/wpcontent/uploads/2022/06/NICD-COVID-19-Weekly-Sentinel-Hospital-Surveillnace-update-Week-23-2022.pdf

9

15.

National Institute for Communicable Diseases. COVID-19 Hospital Surveillance Update: week 12 2022. Published
online 2022. Accessed April 5, 2022. https://www.nicd.ac.za/wp-content/uploads/2022/03/NICD-COVID-19Weekly-Sentinel-Hospital-Surveillnace-update-Week-12-2022.pdf

16.

Relatório de Monitorização da Situação Epidemiológica da COVID-19 Monitoring of COVID-19.
https://www.dgs.pt/em-destaque/relatorio-de-monitorizacao-da-situacao-epidemiologica-da-covid-19-n-12pdf.aspx

17.

Chang CC, Vlad G, Vasilescu ER, et al. Previous SARS-CoV-2 Infection or a Third Dose of Vaccine Elicited CrossVariant Neutralizing Antibodies in Vaccinated Solid Organ Transplant Recipients. Infectious Diseases (except
HIV/AIDS); 2022. doi:10.1101/2022.04.13.22273829

18.

Carazo S, Skowronski DM, Brisson M, et al. Protection against Omicron Re-Infection Conferred by Prior
Heterologous SARS-CoV-2 Infection, with and without MRNA Vaccination. Infectious Diseases (except HIV/AIDS);
2022. doi:10.1101/2022.04.29.22274455

19.

Chemaitelly H, Ayoub HH, Coyle P, et al. Protection of Omicron Sub-Lineage Infection against Reinfection withAnother Omicron Sub-Lineage. Epidemiology; 2022. doi:10.1101/2022.02.24.22271440

20.

Bowen JE, Sprouse KR, Walls AC, et al. Omicron BA.1 and BA.2 Neutralizing Activity Elicited by a Comprehensive
Panel of Human Vaccines. Immunology; 2022. doi:10.1101/2022.03.15.484542

21.

Iketani S, Liu L, Guo Y, Liu L, Huang Y, Wang M. Antibody Evasion Properties of SARS-CoV-2 Omicron Sublineages.
:12.

22.

Yu J, Collier A ris Y, Rowe M, et al. Comparable Neutralization of the SARS-CoV-2 Omicron BA.1 and BA.2 Variants.
Infectious Diseases (except HIV/AIDS); 2022. doi:10.1101/2022.02.06.22270533

23.

Khan K, Karim F, Ganga Y, et al. Omicron Sub-Lineages BA.4/BA.5 Escape BA.1 Infection Elicited Neutralizing
Immunity. Infectious Diseases (except HIV/AIDS); 2022. doi:10.1101/2022.04.29.22274477

24.

Hachmann NP, Miller J, Collier A ris Y, et al. Neutralization Escape by the SARS-CoV-2 Omicron Variants BA.2.12.1
and BA.4/BA.5. Infectious Diseases (except HIV/AIDS); 2022. doi:10.1101/2022.05.16.22275151

25.

Cao Y, Yisimayi A, Jian F, et al. BA.2.12.1, BA.4 and BA.5 Escape Antibodies Elicited by Omicron Infection.
Immunology; 2022. doi:10.1101/2022.04.30.489997

26.

Metzger CM, Lienhard R, Seth-Smith HM. PCR performance in the SARS-CoV-2 Omicron variant of concern? Swiss
Med Wkly. 2021;151(49-50). doi:10.4414/smw.2021.w30120

27.

Drain PK, Bemer M, Morton JF, et al. Accuracy of Rapid Antigen Testing across SARS-CoV-2 Variants. Infectious
Diseases (except HIV/AIDS); 2022. doi:10.1101/2022.03.21.22272279

28.

Soni A, Herbert C, Filippaios A, et al. Comparison of Rapid Antigen Tests’ Performance between Delta (B.1.61.7;
AY.X) and Omicron (B.1.1.529; BA1) Variants of SARS-CoV-2: Secondary Analysis from a Serial Home Self-Testing
Study. Infectious Diseases (except HIV/AIDS); 2022. doi:10.1101/2022.02.27.22271090

29.

Bayart JL, Degosserie J, Favresse J, et al. Analytical Sensitivity of Six SARS-CoV-2 Rapid Antigen Tests for Omicron
versus Delta Variant. Published online 2022:9.

30.

Bekliz M, Perez-Rodriguez F, Puhach O, et al. Sensitivity of SARS-CoV-2 Antigen-Detecting Rapid Tests for Omicron
Variant. Infectious Diseases (except HIV/AIDS); 2021. doi:10.1101/2021.12.18.21268018
10

31.

Takashita E, Kinoshita N, Yamayoshi S, et al. Efficacy of Antiviral Agents against the SARS-CoV-2 Omicron
Subvariant BA.2. N Engl J Med. Published online March 9, 2022:NEJMc2201933. doi:10.1056/NEJMc2201933

32.

Planas D, Saunders N, Maes P, et al. Considerable Escape of SARS-CoV-2 Variant Omicron to Antibody
Neutralization. Immunology; 2021. doi:10.1101/2021.12.14.472630

33.

VanBlargan LA, Errico JM, Halfmann PJ, et al. An Infectious SARS-CoV-2 B.1.1.529 Omicron Virus Escapes
Neutralization by Several Therapeutic Monoclonal Antibodies. Microbiology; 2021. doi:10.1101/2021.12.15.472828

34.

Cameroni E, Saliba C, Bowen JE. Broadly neutralizing antibodies overcome SARS-CoV-2 Omicron antigenic shift.
Published December 14, 2021. Accessed December 23, 2021.
https://www.biorxiv.org/content/10.1101/2021.12.12.472269v1

35.

Roche. Ronapreve does not retain neutralising activity against the Omicron variant. Published 2021. Accessed
December 17, 2021. https://www.roche.com/dam/jcr:dfe6dcb4-d787-45d6-9b1dffc17d667e4c/2021216_Roche%20statement%20on%20Ronapreve%20Omicron.pdf

36.

Arora P, Kempf A, Nehlmeier I, et al. Augmented neutralisation resistance of emerging omicron subvariants
BA.2.12.1, BA.4, and BA.5. The Lancet Infectious Diseases. Published online June 2022:S1473309922004224.
doi:10.1016/S1473-3099(22)00422-4

37.

World Health Organization. Therapeutics and COVID-19: Living guideline. Accessed December 17, 2021.
https://www.who.int/publications/i/item/WHO-2019-nCoV-therapeutics-2021.4

38.

Yamasoba D, Kosugi Y, Kimura I, et al. Sensitivity of Novel SARS-CoV-2 Omicron Subvariants, BA.2.11, BA.2.12.1,
BA.4 and BA.5 to Therapeutic Monoclonal Antibodies. Microbiology; 2022. doi:10.1101/2022.05.03.490409

39.

Higdon MM, Baidya A, Walter KK, et al. Duration of effectiveness of vaccination against COVID-19 caused by theomicron variant. The Lancet Infectious Diseases. 2022;0(0). doi:10.1016/S1473-3099(22)00409-1

11

Risk communication and community
engagement approaches during themonkeypox outbreak in Europe, 2022
Stockholm, 30 June 2022

Introduction
Recent health emergencies in the European Region, such as the COVID-19 pandemic and themulti-country monkeypox outbreak, have reaffirmed the role of Risk Communication andCommunity Engagement (RCCE) as a core public health intervention contributing toemergency response. RCCE is instrumental in achieving results across all the main areas of
response, from laboratory testing, contact tracing and isolation, to treatment andpreventive/protective measures, including vaccination. For all of these measures, successful
implementation is dependent on support from affected individuals and communities.
This document is intended for health authorities designing RCCE interventions in the context
of the current monkeypox outbreak in Europe. It supplements the ‘Interim advice on Risk
Communication and Community Engagement during the monkeypox outbreak in Europe,2022’ [1] jointly published by ECDC and the World Health Organization (WHO) Regional Officefor Europe. It provides examples and approaches for RCCE, while building on experience frompast outbreaks. These examples can be used to inspire countries in the European Region todevelop community engagement approaches and risk communication strategies adapted to
the national, regional and/or local context and specific target audiences in their response to
the ongoing monkeypox outbreak.

General considerations
Anyone can become infected with monkeypox, but the current outbreak in Europe is affecting
gay, bisexual and other men who have sex with men (MSM) disproportionately. Healthauthorities therefore need to make a particular effort to ensure their RCCE is reaching MSM,
and that they consider the messages to be non-stigmatising, credible and actionable.
Collaboration with civil society organisations active in these community groups and withorganisers of events that the groups are likely to attend (e.g. Pride events) is an effective way
to achieve this.
RCCE interventions may be developed and carried out by different stakeholders including
public health authorities, civil society organisations and other non-governmental organisation(NGOs), academic institutions and event organisers. When public health authorities aredesigning such interventions, it is of the utmost importance that representatives of thecommunity, such as civil society organisations, are consulted during the development phase,including on the communication channels, the communicator and the messages most suitablefor outreach to target audiences. The context they can provide on their communities – forEuropean Centre for Disease Prevention and Control/World Health Organization Regional Office for Europe. Risk communicationand community engagement approaches during the monkeypox outbreak in Europe, 2022. 30 June 2022.
Stockholm/Copenhagen; ECDC/WHO Regional Office for Europe: 2022.
© European Centre for Disease Prevention and Control, Stockholm, 2022.
© World Health Organization 2022. Some rights reserved. This work is available under the Creative Commons Attribution- 3.0
IGO licence (CC BY-3.0 IGO; Creative Commons — Attribution 3.0 IGO — CC BY 3.0 IGO).

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Risk communication and community engagement approaches during the monkeypox outbreak in Europe, 2022

example on perceptions, values, behaviour and trust – is key to crafting effective risk
communication interventions. Moreover, it is important to note that even well-intended
messages may be considered stigmatising, depending on the communication channel used,the communicator, the audience reached or the message itself. This is why it is essential topartner with community based organisations, civil society organisations and communities indesigning and implementing RCCE approaches.
This document presents experiences from several of the countries affected by the outbreak(Belgium, Croatia, France, Ireland, Portugal, Spain, Sweden and UK) relating to the use oftrusted communicators, targeted channels and community engagement approaches to reach
MSM and other risk groups, and prevent stigmatisation. These practices, and comparable
examples from other outbreaks, can serve as specific examples of RCCE for other Member
States who may be facing similar challenges.

Examples of risk communication and community
engagement approaches
Trusted communicators
Trusted communicators can include:
•
•
•
•
•
•
•
•

trusted government spokespersons;health professionals, including those identifying as MSM;
community champions;pre-existing health sector and civil society platforms/networks on HIV and MSM sexual
health issues;
civil society organisations (e.g. those working with sexual health rights and LGBT+
community advocates);leaders of different advocacy groups, working in health generally or in sexual health;event companies/organisers and/or hosts;
managers of LGBT+ bars, night clubs, saunas and sex-on-the-premises venues (SOPVs).

During an outbreak, building and establishing trust with the affected community is extremely
important for the acceptance and uptake of measures. Therefore, the use of trusted
communicators for risk communication is critical. The selection of the appropriate
communicators depends on the groups affected. In the case of the ongoing monkeypox
outbreak, emphasis should be placed on communicators who are members of, leaders withinor individuals who have long-standing relationships with MSM groups and/or the LGBT+
community.

Communication channels
Public-facing channels (i.e. channels addressing the general public) include:•••

national and local health authority websites;
national and local health authority social media accounts;
media interviews or broadcasts with trusted spokespersons.

These are more traditional channels of communication. National and local public healthwebsites and their social media accounts are important for publishing regular reports andupdates on the situation. They are regularly used by health journalists as a source for further
reporting and can be a good reference for managing rumours and misinformation. In addition,these accounts regularly publish material containing health information and advice (e.g.
leaflets, infographics, etc.) which can be used for risk communication interventions.

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Risk communication and community engagement approaches during the monkeypox outbreak in Europe, 2022

Table 1. Examples of public-facing channels used in the current multi-countrymonkeypox outbreak
ChannelHealth authority websites

Health authority social media

Media interviews with trusted
spokespersons

Trusted spokespersons at events

Example• Webpages have been set up in many countries and by institutions including
ECDC, WHO and the UK Health Security Agency (UKHSA), among others.
These websites include guidance for the public, health authorities and healthprofessionals. They also include epidemiological updates and links to press
briefings. Frequently asked questions (FAQs), key facts and relevant training
materials may all also be linked to these webpages.
• In several countries the official Twitter accounts of health authorities are used forweekly epidemiological updates and to report key information on prevention andcare-seeking, if a person suspects they are infected [2-6]. These posts areaccompanied by social media tiles and sometimes also infographics.
• Institutions or prominent public health officials, for example WHO Regional
Office for Europe’s Regional Director, Hans Kluge, have used their social
media platforms to share health information and advice and amplify Twitteror Facebook posts from other health authorities, to increase coverage [7].
• Steve Taylor, Board Member of EURO Pride, Organiser of Copenhagen Pride, andco-Founder of Global Pride 2020, was invited by WHO Regional Office for Europe
to participate in a formal press briefing to speak about the opportunity provided
by mass gatherings during the summer to raise awareness and share publichealth messaging on monkeypox [8]. He subsequently shared this formal press
briefing to his followers and online communities.
• Epidemiologists from UK HSA provided information on monkeypox in shortvideos, including advice for Pride events [2,3].
• PrEPster, a project of the civil society organisation The Love Tank from theUK hosted streamed information sessions with Dr. Will Nutland of the London
School of Hygiene and Tropical Medicine, and colleagues from the UK HSA to
inform their followers about monkeypox and how to reduce risk, prevent
transmission and seek care [9].
• At several Pride events across Europe, popular drag queen hosts have beencollaborating with organisers and public health authorities to give healthinformation and advice messages.

Targeted channels can include:•

civil society and non-governmental organisations, including websites and media used
specifically by MSM and wider LGBT+ community;• mass gathering and other event channels (e.g. summer tourism agencies and event
planners, including those for organising Pride events, summer music festivals, fetish
festivals, island parties), including webpages and social media accounts. These are richsettings for information outreach and engagement;• dating applications (apps) - as the virus can be spread through close contact, including during
sexual activities, dating apps may reach people who engage with multiple sexual partners;• social networking apps that could reach target groups (e.g. MSM and wider LGBT+), suchas Facebook, Instagram, TikTok, etc.;• bars, saunas, or sex clubs that can use their websites, put up posters at their venues, orshare information on their social media pages;• health clinics and sexual health service websites;• university websites and social media accounts.
Social media and other digital channels reach a larger audience in younger age groups and a
growing number of people from all adult groups [10]. During the current outbreak, and due tothe large number of planned mass gathering events, use of these channels should be
exploited to the maximum to increase knowledge of the outbreak and provide credible andactionable information and advice to the groups most at risk. If using digital channels to reach
MSM or other groups, lessons learned from previous experiences with these channels may be
useful for sharing prevention information and practices. Various guides detailing digitalapplications used for HIV prevention activities can be in ECDC’s report ‘Effective use of digitalplatforms for STI/HIV prevention among MSM in the EU/EEA’ [11].
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Risk communication and community engagement approaches during the monkeypox outbreak in Europe, 2022

Table 2. Examples of targeted channels used in the current multi-countrymonkeypox outbreak
ChannelMass gatherings

Dating applications(apps)

Civil society and nongovernmentalorganisation (NGO)websites and social
media

Example• Mass gatherings can be an opportunity for risk communication before, during
and after an event.
• In preparation for the Glastonbury festival in the UK, key messages on sexual
health and prevention of infectious disease were added to the festival website.
Folded leaflets with condoms or lubricants, posters and bracelets with QR codes
have been designed with civil society and public health professionals to provide
advice on prevention of all sexually transmitted and infectious diseases. The
messaging has remained transparent, but not solely focused on monkeypox, so
as to not to stigmatise specific groups.
• ECDC and WHO Regional Office for Europe have been working with the European
Pride Organisers Association (EPOA), The Love Tank, and PrEPster to develop atoolkit of where and what to communicate to the participants at Pride events. The
toolkit also includes multimedia elements, such as recorded messages, mini clips
to broadcast on screens, and health advice posters to post at events.
• After the Darklands Festival in Belgium, when several monkeypox cases wereconfirmed, the Federal Risk Assessment Group in Belgium worked with thefestival organisers to post messages on their website indicating when and how
to seek care for suspected monkeypox cases [12]. The festival organisers linked
to public health messages from the Belgian health authorities and sent
messages out to participants.
• In collaboration with Grindr and Hornet, ECDC has provided an information flash
to all their users, including links to further information by ECDC and/or national
health authorities and to the European Test Finder website(https://www.testfinder.info/). The key message was designed by public healthprofessionals and community partners and adapted by the apps communication
team. The pop-up message was translated into several languages and, whereavailable, was provided in the language of the user’s country (see Figure 1
below). A similar message was sent as an inbox message to users (i.e. themessage is sent to the inbox of the app and is therefore available to the user at
a later date). This message was translated into 29 languages and, if available,
included a link to a relevant national website.
• MSM sexual health campaigns such as MPOWER in Ireland and PrEPster/The Love
Tank in the UK, have also sent out messaging via dating apps. The Grindr Equality
foundation provides some advertising for free on the Grindr app to healthauthorities and LGBT+ community organisations. Sexual health campaigns are alsoable to pay for advertising on Grindr [13].
• More information on the use of dating apps for HIV and STI prevention has been
produced by ECDC [11].
• In Ireland and Portugal, public health authorities and civil society organisations
were already working together on sexual health outreach, engagement andcommunication with MSM. From May 2022, these campaigns havecommunicated on monkeypox:- GAT in Portugal [14],- MPOWER [15] and Man2Man in Ireland [16].
• Spain initiated a campaign led by the Ministry of Health, in close collaboration
with their NGO advisory committee, for the summer season and events covering
sexual health, monkeypox and COVID-19, not only focusing on MSM [17].
• PrEPster, a project of The Love Tank, streamed live information sessions on asocial networking website to inform their followers about monkeypox and how to
reduce risk, prevent transmission and seek care [9].
• Queer Health (also a project of The Love Tank), a website that shares healthinformation for people identifying as LGBT+, has set-up a page dedicated tomonkeypox [18]. The website is available in multiple languages and includes
information on monkeypox in the EU, FAQs and information from other key
stakeholder websites, such as NGOs working on HIV.
• The Terrence Higgins Trust in the UK has also set up a website on monkeypox,
providing updated information on the disease [19].
• The Deutsche Aidshilfe, an umbrella organisation of around 120 organisations inGermany representing the interests of people living with HIV/AIDS, has set up a
webpage with a summary of key facts on monkeypox and a Q&A, including links
to the websites of public health authorities [20].

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Risk communication and community engagement approaches during the monkeypox outbreak in Europe, 2022

ChannelLeveraging the existing
telephone hotlines ofcommunity-basedorganisations
Frequently attended
locations
Health clinics

Example• In Croatia, targeted social media posts and paid ads have been used to inform
MSM and related communities about monkeypox using simple language.
• In Portugal, risk communication materials on monkeypox give the numbers of atelephone hotline run by GAT, a community-based organisation that works on
HIV/STI testing and access to care. They also give the number of the telephone
hotline service for the Portuguese health service. People can ring these numbers toreceive further information on monkeypox and arrange testing and access to care.
• In the UK [18] and Croatia, civil society organisations have been working withpublic health authorities to share health information and advice on monkeypox
with the managers of saunas, clubs and other venues frequented by men who
have sex with men.
• In Sweden, the Västernorrland region has provided information for clinicians on
testing, diagnosis and treatment of monkeypox, in addition to information thatclinics should distribute to patients, such as information leaflets designed by the
Swedish infection control units [21].
• The Swedish infection control units work with the Swedish Medical Association toensure that online translation is available for these information leaflets [22].
• In Croatia, printed information leaflets about monkeypox have been distributed
in different clinical settings (community-based testing sites for MSM, PrEP clinics,
HIV clinics, etc.).

Figure 1. Multilingual push messages in Grindr and Hornet applications on themonkeypox outbreak, 2022
Pleas

Adapted messages
Key messages should be adapted to the target audience and the communication channel used.
Following the principles of community engagement, public health authorities should at all times
strive to include civil society actors or community-based organisations in the design andadaptation of messages. Communities are often best placed to tailor a message to their members’context and language. For the purposes of mass gatherings, multilingual messages should beconsidered [23] .
Suggested key messages can be found in the initial risk communication advice document
published by ECDC and WHO [1]. In principle they should include elements such as symptoms ofmonkeypox, what to do if a person suspects they have monkeypox, what to do if a person tests
positive for monkeypox, and what type of treatment exists. An example of this type of document
has been produced by ECDC experts in collaboration with civil society organisations: ‘Navigatingmonkeypox: considerations for gay and bisexual men and other men who have sex with men’.
This document provides tailored messages to inform MSM in Europe about monkeypox

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Risk communication and community engagement approaches during the monkeypox outbreak in Europe, 2022

transmission, systems, testing and self-care [24]. WHO experts have also produced public healthadvice for larger population groups, including those at highest risk of infection [25].
In addition, field experience has shown that combining messages on monkeypox with otherpublic health advice which may be more familiar to the target audience (e.g. HIV prevention,
harm reduction, etc.) may be a better approach for acceptance and uptake of protective
measures.

Community engagement with civil society organisations
Public health authorities at national and sub-national level need to identify and actively workwith relevant civil society organisations, community-based organisations and stakeholders.
This will make it possible to leverage the trust that these organisations have to ensure thatthe affected and at-risk groups are properly informed and empowered to protect themselvesfrom the disease. This includes communicating in relevant and culturally appropriate
languages and employing the communication channels used by their members [26].
The activities for which public health authorities may work together with these organisations
include:
•

•
•
•
•
•

building an understanding of the perceptions and concerns of those affected and at risk inrelation to the outbreak (through qualitative research, such as focus group discussions,intercept interviews and social listening);
facilitating the co-design and testing of risk communication interventions and messaging;
providing advice on the appropriate language to use;
amplifying public health advice through trusted community champions;monitoring rumours and misinformation, and helping to debunk them;monitoring people’s acceptance and adherence to protective measures.

Priority groups and examples
The following groups have been identified as priorities for community engagement, given theirincreased risk of exposure to monkeypox and/or possibility of more serious disease. The
examples below provide community engagement strategies used with these groups duringmonkeypox and other outbreaks. These examples are not exhaustive, they do not reflect all
activities going on in Europe at the time of publication, and are likely to change and adapt as
the monkeypox situation evolves.

MSM
•

•

A coalition of civil society organisations active on sexual health issues, healthcare providers
and the UK Health Security Agency have worked together to communicate to and engage
with gay, bisexual and other men who have sex with men. Actions have included:− jointly branded webcasts on monkeypox between UK HSA and PrEPster/The Love
Tank, civil society organisations working on sexual health issues with men who havesex with men;
− a social media video clip of a UK HSA expert who is also a gay man talking aboutmonkeypox and its symptoms;− outreach in relation to monkeypox to the managers of saunas, clubs and othervenues frequented by MSM;
− development of guidance on cleaning and disinfection relating to monkeypox, aimed
at SOPVs;− communication and outreach on social media, including on dating/hook-up apps suchas Grindr.
Online communication campaigns (websites and social media channels) relating tomonkeypox by existing HIV/sexual health campaigns (Ireland, Portugal, UK), civil society
organisations (Croatia, Lithuania) and Pride organisations (Baltic Pride).

6

TECHNICAL REPORT

•
•
•

•

Risk communication and community engagement approaches during the monkeypox outbreak in Europe, 2022

Putting up posters about monkeypox with links to online campaigns in bars and SOPVs(Ireland) and at face height above urinals at festivals (UK).
Giving out printed information leaflets about monkeypox at venues frequented by MSM,
such as nightclubs and saunas (Croatia).
In Portugal, the Direção-Geral da Saúde/Directorate-General of Health (DGS) has beenworking with the civil society organisation Grupo de Ativistas em Tratamentos (GAT) that
deals with HIV/STI testing and access to care. The objective was to find pragmatic andfeasible prevention measures and information, addressing the need to target thosegroups most at risk (namely MSM), without stigmatising or blaming. To better disseminate
existing advice developed by DGS and based on ECDC and WHO Regional Office forEurope’s joint RCCE publication, GAT and DGS held online sessions with community-basedorganisations. The collaboration also resulted in specific strategies for two mass
gatherings in Lisbon (Marcha do Orgulho LGBTI+ and Arraial Lisboa Pride). Materials
were designed by GAT, and a plan was developed for the distribution of informationmaterials. Furthermore, it was decided to set up HIV/STI testing in mobile units, during
which specific advice on monkeypox prevention, symptoms, and where to get tested,
could be given out. The information material was a small, pocket-sized bilingual(Portuguese and English) card, designed by GAT, with an image intended not to alarm,calling attention to symptoms (bumpy cucumber). The card described essential
information (symptoms, what to do if having symptoms, who to call for support (a GAT
helpline and the number of the Portuguese national health service number (SNS 24)).
The public health authorities and civil society organisations in Ireland have worked
together closely for many years on prevention and treatment of HIV, viral hepatitis andsexual health issues. Two important platforms to communicate and engage with gay,bisexual and other men who have sex with men (gbMSM) in Ireland on health issues are:www.man2man.ie which is administered jointly by the Gay Health Network CSO andIreland’s health authority, the Health Service Executive (HSE); and the MPOWER
Programme (mpower.hivireland.ie) which is run by the civil society organisation HIV
Ireland, but also has a strong working relationship with the HSE. In May 2022, when thefirst case of monkeypox was identified in Ireland, these platforms collaborated andworked with HSE on a joint RCCE campaign concerning the new disease. Key actions
have included:−
Community leaders’ briefings, bringing together LGBT+ CSOs, sexual healthorganisations, venue managers and Pride/LGBT+ event organisers. These have been
opportunities to foster collaboration and co-create joint actions, as well as to raiseawareness about monkeypox and how to prevent it.
−
Co-creation of messages and materials between civil society organisations and healthauthorities, so that messages are understandable and actionable without being
stigmatising.
−Advertising on gbMSM media platforms and via dating apps.
−
Community outreach at venues and events (Figure 2A).
−
Putting up posters about monkeypox in LGBT+ venues, including in SOPVs (Figure 2B).
−
Providing information to drag queens/comperes at LGBT+ venues so they cancommunicate with their audience on monkeypox.
−
Video clips about monkeypox played on large screens at the Dublin Pride events on
24−26 June 2022 and regular stage announcements.
−
The Dublin Pride event will be followed by a virtual town hall meeting with
community members co-organised by MPOWER, to gauge the impact of thecampaign, update attendees on the current situation and encourage further healthseeking behaviour.

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Risk communication and community engagement approaches during the monkeypox outbreak in Europe, 2022

Figure 2. Examples of outreachFigure 2A Outreach workers at an LGBT+ venue in Ireland distributing flyers on monkeypox.
Figure 2B. Posters about monkeypox in toilets at an LGBT+ venue in Ireland.

A

B

Photo credit: MPOWER, Ireland.

Sex workers•

Existing sex worker organisations and networks can facilitate access to this populationand the implementation of appropriate prevention messaging and contact tracing
strategies. During COVID-19, the Deutsche Aidshilfe, a German NGO, provided
recommendations on COVID-19 prevention for sex workers [27]. Similarly, the state ofQueensland in Australia designed guidelines on COVID-19 prevention and control with sex
workers and sex worker businesses [28]. The document served as a checklist forbusinesses and individual sex workers to reduce the risk of transmission, screen clientsfor potential infection and provide support for contact tracing.

Healthcare workers•

Infection prevention and control guidance, and testing and management guidelines
addressing healthcare professionals have been developed by many public healthauthorities including WHO [29], UK HSA [30], and the US Centers for Disease Control andPrevention [31] .

Immunocompromised people, pregnant women, and children••

In France, during COVID-19 the national public health authority, Santé Publique France,
worked with the network of Centres for Information, Testing, and Diagnosis (CeGIDD)
across France to communicate on the potential risks faced by immunocompromised people,
how to reduce these risks and prevent transmission. The CeGIDD, in turn, mapped andengaged civil society and associations working on HIV to adapt their testing, and support
strategies (access to food, mental health support related to isolation, etc.) to the realities
faced by people living with HIV (PLHIV) during COVID-19 [32]. In this way, adapted
solutions to prevention, testing, and treatment were developed together with civil society
and groups supporting PLHIV, in collaboration with public health authorities.
The European AIDS Clinical Society (EACS) [33] and the British HIV Association [34] haveboth issued statements about monkeypox to guide clinicians caring for and people livingwith HIV. Both organisations indicated that people who are not virally suppressed are more
likely to need specialist review and be at higher risk of severe outcomes if they contractmonkeypox.
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Risk communication and community engagement approaches during the monkeypox outbreak in Europe, 2022

Stigmatisation
The following presents strategies that can be used to prevent and counter stigmatisation.
•••

Use respectful and inclusive language: to stress that monkeypox is not a disease linked tosexual orientation. For example, ECDC and WHO Regional Office for Europe are working
with civil society actors representing affected groups to design their guidance for men
who have sex with men, and with event organisers. These civil society representatives
are asked to review messaging to ensure it is respectful towards and inclusive of theaffected groups.
Monitor public perceptions of MSM. For example, WHO Regional Office for Europe has asocial listening team that is monitoring trends related to the perception of MSM in the
broader population with regard to monkeypox, general sentiment, and the spread of mis
and disinformation. This monitoring informs public health authorities on what mis or
disinformation may need to be debunked, and what risk communication messages mayneed to be enforced.
Concentrate most of the RCCE activities on channels and outreach activities thatspecifically target the most affected community group (currently MSM).

ECDC authors (in alphabetical order)
Agoritsa Baka, Benjamin Bluemel, Orlando Cenciarelli, Teymur Noori, Anastasia Pharris,
Gabrielle Schittecatte.

WHO Regional Office for Europe authors (in alphabeticalorder)Ben Duncan, Cristiana Salvi.

Contributors
Berta Suárez Rodríguez, Ministry of Health, Spain.
Julia del Amo, Ministry of Health, Spain.
Zoran Dominković, Iskorak, Croatia.
Ricardo Fuertes, Directorate-General of Health, Portugal.
Adam Shanley, MPOWER at HIV Ireland, Ireland.
Will Nutland, The Love Tank CIC and The London School of Hygiene and Tropical Medicine.
Uldis Mitenbergs, WHO Country Office, Latvia.
Ingrida Zurlyte, WHO Country Office, Lithuania.

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References
1.

2.
3.
4.

5.

6.
7.

8.

9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.

European Centre for Disease Prevention and Control (ECDC) and World Health Organization Regional Officefor Europe (WHO/Europe). Interim advice on Risk Communication and Community Engagement during themonkeypox outbreak in Europe, 2022. Stockholm and Copenhagen: ECDC and WHO/Europe; 2022. Available
at: www.ecdc.europa.eu/en/publications-data/interim-advice-risk-communication-and-communityengagement-during-monkeypox
UK Health Security Agency. @ProfKevinFenton talks about #Monkeypox cases, what we're asking people tolook out for & what to do if you have symptoms. Twitter. 6 June 2022 12:42:00 PM. Available at:https://twitter.com/UKHSA/status/1533761240128004098
UK Health Security Agency. WATCH @teozka gives advice on having a happy, safe and healthy #Pride to
everyone celebrating & what people should look out for with #Monkeypox. Get the latest updates. Twitter. 1
June 2022 12:44:00 PM. Available at: https://twitter.com/UKHSA/status/1531949696800935937
SantépubliqueFrance. [#Monkeypox] L’incubation de la maladie peut aller de 5 à 21 jours. La phase de fièvre
dure environ 1 à 3 jours. La maladie guérit le plus souvent spontanément, au bout de 2 à 3 semaines.
Twitter. 25 May 2022 12:50:00 PM. Available at:https://twitter.com/SantePubliqueFr/status/1529414564248444935
SantépubliqueFrance. [#VarioleDuSinge] Point de situation au 16 juin 2022 à 14h. 183 cas confirmés devariole du singe ont été rapportés en France #Monkeypox Pour en savoir plus
https://santepubliquefrance.fr/les-actualites/2022/cas-de-variole-du-singe-point-de-situation-au-16-juin-2022.
Twitter. 17 June 2022 11:17:00 AM. Available at:https://twitter.com/SantePubliqueFr/status/1537726014503231488
Robert Koch-Institut. 521 #Affenpocken-Fälle (+52 zum Vortag) aus 14 Bundesländern und 72 Kreisen sindinsgesamt ans #RKI übermittelt worden. Weitere Fälle sind in Germany zu erwarten. Twitter. 22 Jun 2022
09:08:00 AM. Available at: https://twitter.com/rki_de/status/1539505566577483778
Hans Kluge. With summer tourism, Pride events, music festivals & other mass gatherings planned in Europe,
these events are powerful opportunities to engage with young, sexually active & highly mobile people andshare information on monkeypox. Valuable guidance from @WHO_Europe & @ECDC_EU. Twitter. 16 June
2022 11:15:00 AM. Available at: https://twitter.com/hans_kluge/status/1537363273665982466
WHO/Europe. Thank you to @danophile who spoke at our media briefing about why large events &celebrations - including @EuroPride - are an important opportunity to raise awareness about the #monkeypox
outbreak, ensuring people get the right information to protect themselves. . Twitter. 16 June 2022 04:23:00.
Available at: https://twitter.com/WHO_Europe/status/1537440834022387713
Prepster. Monkeypox: everything we know so far. Facebook. 26 May 2022. Available at:www.facebook.com/prepster.info/videos/monkeypox-everything-we-know-so-far/2567254223407373/
Pew Research Center. News Use Across Social Media Platforms in 2020. Washington: Pew Research Center;
2021. Available at: https://www.pewresearch.org/?topic-page=digital-news-landscapeEuropean Centre for Disease Prevention and Control (ECDC). Effective use of digital platforms for STI/HIV
prevention among MSM in the EU/EEA. Stockholm: ECDC; 2017. Available at:www.ecdc.europa.eu/en/effective-use-digital-platforms-stihiv-prevention-among-msm-eueea
Darklands Festival. This is an important message to all visitors of Darklands 2022 regarding confirmed casesof the Monkeypox virus. 2022. Available at: https://darklands.be/monkeypox/
Grindr. Grindr for Equality. West Hollywood: Grindr; 2022. Available at: https://www.grindr.com/g4e/
Grupo de Ativistas em Tratamentos (GAT). Monkeypox: sinais, sintomas e o que fazer. Lisbon: GAT; 2022.
Available at: https://www.gatportugal.org/noticias/monkeypox-sinais-sintomas-e-o-que-fazer_168
HIVIreland. Monkeypox - What You Need to Know. Dublin: HIVIreland; 2022. Available at:https://mpower.hivireland.ie/monkeypox/
Man2Man.ie. Let’s Talk About… Monkeypox. Dublin: Gay Health Network (GHN) and the Health Services
Executive (HSE); 2022. Available at: https://man2man.ie/lets-talk-about/monkeypox/
Ministerio de Sanidad. Este Verano la Fiesta es Saludable. Madrid: Gobierno de España; 2022. Available at:https://www.sanidad.gob.es/ciudadanos/enfLesiones/enfTransmisibles/sida/VIRUELADELMONO/esteveranolaf
iesta.htm
Queer Health. Everything we know about Monkeypox (MPX) so far. Available at:https://www.queerhealth.info/projects/monkeypox
Terrence Higgins Trust (THT). Monkeypox in the UK. London: THT; 2022. Available at:www.tht.org.uk/news/monkeypox-uk
Deutsche Aidshilfe (DAH). Affenpocken. Berlin: DAH; 2022. Available at: www.aidshilfe.de/affenpocken
Region Västernorrland. Apkoppor (monkeypox). Härnösand: Region Västernorrland; 2022. Available at:www.rvn.se/sv/for-vardgivare/Smittskydd/smittor/apkoppor-monkeypox/
Smittskyddsläkarföreningen. Smittskyddsblad. Stockholm: Sveriges läkarförbund; 2022. Available at:https://slf.se/smittskyddslakarforeningen/smittskyddsblad/
European Centre for Disease Prevention and Control (ECDC) and World Health Organization Regional Officefor Europe (WHO/Europe). Interim advice for public health authorities on summer events during themonkeypox outbreak in Europe, 2022. Stockholm: ECDC and WHO/Europe; 2022. Available at:www.ecdc.europa.eu/en/publications-data/interim-advice-public-health-authorities-summer-events-duringmonkeypox-outbreak

10

TECHNICAL REPORT

Risk communication and community engagement approaches during the monkeypox outbreak in Europe, 2022

24. European Centre for Disease Prevention and Control (ECDC). Navigating monkeypox: considerations for gay
and bisexual men and other men who have sex with men, 2022 Stockholm: ECDC; 2022. Available at:www.ecdc.europa.eu/en/publications-data/navigating-monkeypox-considerations-gay-and-bisexual-men-andmsm
25. World Health Organization - Regional Office for Europe (WHO/Europe). Public health advice on the recent
outbreak of monkeypox in the WHO European Region. Copenhagen: WHO/Europe; 2022. Available at:https://www.who.int/europe/publications/m/item/public-health-advice-on-the-recent-outbreak-ofmonkeypoxin-the-who-european-region.-24-may-2022
26. European Centre for Disease Prevention and Control (ECDC). Community engagement for public health
events caused by communicable disease threats in the EU/EEA, 2020. Stockholm: ECDC; 2020. Available at:www.ecdc.europa.eu/en/publications-data/guidance-community-engagement-public-health-events-causedcommunicable-disease
27. Deutsche Aidshilfe (DAH). Sexarbeit und Corona. Berlin: DAH; 2022. Available at: www.aidshilfe.de/sexarbeitcorona
28. Queensland Government. COVID Safe Industry Plan: Queensland Sex Industr. Barcaldine: Queensland
Government; 2021. Available at: https://www.covid19.qld.gov.au/government-actions/covid-safechecklist/queensland-sex-industry
29. World Health Organization (WHO). Clinical management and infection prevention and control for monkeypox:
Interim rapid response guidance. Geneva: WHO; 2022. Available at: www.who.int/publications/i/item/WHOMPX-Clinical-and-IPC-2022.1
30. UK Health Security Agency (UKHSA). Monkeypox: guidance. Information and advice for healthcare
professionals and the general public. London: UKHSA; 2022. Available at:www.gov.uk/government/collections/monkeypox-guidance#guidance-for-health-professionals-and-serviceproviders
31. Centres for Disease Control and Prevention (CDC). Information For Healthcare Professionals. Atlanta: CDC;
2022. Available at: www.cdc.gov/poxvirus/monkeypox/clinicians/index.html
32. Agence Regional de Sante (ARS) Île-de-France. Journée mondiale de lutte contre le sida et COVID-19: l’ARSÎle-de-France mobilisée. Saint-Denis: ARS Île-de-France; 2020. Available at:https://www.iledefrance.ars.sante.fr/journee-mondiale-de-lutte-contre-le-sida-et-covid-19-lars-ile-de-francemobilisee
33. European AIDS Clinical Society (EACS). Monkeypox in Europe - EACS Statement. Brussels: EACS; 2022.
Available at: www.eacsociety.org/about-eacs/news/eacs-statement-on-monkeypox-in-europe/
34. British HIV Association (BHIVA). BHIVA rapid statement on monkeypox virus. Letchworth: BHIVA; 2022.
Available at: www.bhiva.org/BHIVA-rapid-statement-on-monkeypox-virus

11Vaccination Report – 5 July 2022
1. Vaccine Implementation

1WHO’s Emergency Use Listing(EUL) Vaccines (Last Updated 26 May 2022）
Manufacturer

Name of Vaccine

NRA of Record

Vaccine type

Pfizer-BioNTech(US)

BNT162b2/COMIRNATY
Tozinameran (INN)

EMA,USFDAmRNA

AZD1222 Vaxzevria

EMA,
MFDS KOREA,
Japan MHLW/PMDA,
Australia TGA,
COFEPRIS(Mexico),
ANMAT(Argentina)

Non ReplicatingViral
vector

DCGI

Non Replicating Viral
Vector2

AstraZeneca(UK)

3

Serum Institute of India(India)4

Johnson &Johnson(US)

Ad26.CoV2.S

EMA, DCGINon ReplicatingViral
vector5Moderna(US)

mRNA-1273

EMA, USFDA, MFDS

mRNA

6

Sinopharm Beijing(China)SARS-CoV-2
Vaccine(Vero Cells)

NMPA

Inactivated virus(Vero Cells)

7

Sinovac(China)COVID-19 Vaccine(Vero Cells)

NMPA

Inactivated virus(Vero Cell)

8

Bharat Biotech(India)SARS-CoV-2 Vaccine,
Inactivated (Vero Cell)/
COVAXIN

DCGI

Whole-Virion Inactivated(Vero Cell)

Serum Institute of India(India)NOVAVAX(US)CanSinoBIO(China)

9
10
11



Covishield(ChAdOx1_nCoV-19)

DCGI

NVX-CoV2373/Covovax

Protein Subunit

EMA

NVX-CoV2373/Covovax

Protein Subunit

NMPA

Ad5-nCoVNon ReplicatingViral
vector

40 Vaccines Approved by at Least One Country

VaccineTypemRNA

Non Replicating
Viral vector

Inactivatedvirus

Protein
SubunitDNA

Virus-like
Particles
(VLP)

Total

In Use

4

7

11

16

1

1

40

Source: https://covid19.trackvaccines.org/vaccines/ （Last Updated 1 July 2022）

Vaccination against COVID-19 has now started in 218 locations

(Source: Our World in Data. Last Updated 4 July 2022)
Location
Worldwide

Doses Given
12.12 billion

Complete Initial Protocol(% of population)
4.82 billion(61.20 %)Partly Vaccinated(% of population)
5.25 billion(66.72 %)About this data:
a: This data changes rapidly and might not reflect doses still being reported. It may differ from other sites & sources.
b: Where data for full vaccinations is available, it shows how many people have received at least 1 dose and how
many people have been fully vaccinated (which may require more than 1 dose).Where data for full vaccinations isn't
available, the data shows the total number of vaccine doses given to people. Since some vaccines require more than
1 dose, the number of fully vaccinated people is likely lower.
c: It only has full vaccination totals in some locations.

2. Vaccine effectiveness against symptomatic infection for Alpha, Delta andOmicron variants
Vaccine Status
Alpha
1

1 Dose (BNT162b2 or
ChAdOx1 nCoV-19)
1 Dose (mRNA-1273)
1 Dose(Sinopharm or
Sinovac)
2 Doses (BNT162b2)

48.7% (95%CI: 45.5-51.7%)
66% (BNT162b2)4
64% (ChAdOx1)4
83% 4

Vaccine Effectiveness
Delta
30.7% (95%CI: 25.2-35.7%)1
56% (BNT162b2)467% (ChAdOx1)4
82% (95% CI:73- 91%) 7
72% 4

Omicron13.8% ,(95%CI: -60.2-54.8%)3
93.7% (95%CI: 91.6-95.3)1
76% (95%CI: 69-81%)2
89% 4

88% (95%CI: 85.3-90.1%)1
42% (95% CI: 13-62%)2
87% 4

50% (95% CI: 35%–62%)8

93% (95% CI: 88-97%/12-18Y)5
93% (95% CI: 88-97%)7
2 Doses (ChAdOx1
nCoV-19)

74.5% (95%CI: 68.4-79.4%)1

67.0% (95%CI: 61.3-71.8%)1

2 Doses (mRNA-1273)

86% , (95%CI: 81-90.6%)2

76% , (95% CI: 58-87%)2

2 Doses(Sinopharm or
Sinovac)59.0% , (95%CI: 16.0-81.6%)3

3 Doses (BNT162b2)

95.33% (SD 6.44)6
86.1% (95% CI, 67.3 to 94.1)11

3 Doses(mRNA-1273)

30.4% (95% CI: 5.0%-49.0%)9

67.2% (95% CI: 66.5- 67.8%)
at 2 to 4 weeks10
49.4% (95% CI, 47.1 to 51.6)11
52.2% (95% CI, 48.1 to 55.9)12
62.5% (95% CI: 56.2-67.9%)9
47.3% (95% CI, 40.7 to 53.3)11

2 Doses (BNT162b2) +1Dose(mRNA-1273)

73.9% (95% CI: 73.1- 74.6%)

2 Doses(ChAdOx1
nCoV19)+1Dose(BNT162b2)
2 Doses (ChAdOx1
nCoV-19)+ 1Dose(mRNA-1273)

62.4% (95% CI, 61.8- 63.0) at

at 2 to 4 weeks10
2 to 4 weeks10
70.1% (95% CI, 69.5 to 70.7)
at 2 to 4 weeks10

References:
1) Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant2) Comparison of two highly-effective mRNA vaccines for COVID-19 during periods of Alphaand Delta variant prevalence3) Efficacy of inactivated SARS-CoV-2 vaccines against the Delta variant infection in
Guangzhou: A test-negative case-control real-world study4) Effectiveness of COVID-19 vaccines against variants of concern in Ontario, Canada
5) Effectiveness of BNT162b2 Vaccine against Delta Variant in Adolescents
6) A RCT of a third dose CoronaVac or BNT162b2 vaccine in adults with two dosesof CoronaVac
7) Effectiveness of BNT162b2 Vaccine against Delta Variant in Adolescents
8) Effectiveness of BNT162b2 Vaccine against Omicron Variant in South Africa
9) Effectiveness of mRNA-1273 against SARS-CoV-2 omicron and delta variants10) Covid-19 Vaccine Effectiveness against the Omicron (B.1.1.529) Variant11) Effect of mRNA Vaccine Boosters against SARS-CoV-2 Omicron Infection in Qatar
12) Effects of Previous Infection and Vaccination on Symptomatic Omicron Infections

3. Latest Relevant Articles


BNT162b2 Effectiveness and Durability Against BA.1 and BA.2 Hospital andEmergency Department Admissions in a Large US Health System: A Test-Negative
Design (Posted on June 30, 2022)

Exosomes decorated with a recombinant SARS-CoV-2 receptor-binding domain
as an inhalable COVID-19 vaccine (Posted on July 4, 2022)



BNT162b2 Vaccine Effectiveness against Omicron in Children 5 to 11 Years of Age(Posted on June 29, 2022)



Neutralization of the SARS-CoV-2
Subvariants(Posted on June 30, 2022)

Immunogenicity and Safety ofVaccine(Posted on June 29, 2022)

OmicronBeta-Adjuvanted

BA.4/5

andRecombinant

BA.2.12.1
Booster

4. Other Information


CDC: COVID-19 Vaccine Provider Availability and Vaccination Coverage AmongChildren Aged 5–11 Years — United States, November 1, 2021–April 25, 2022
(Posted on July 1, 2022)



Quarterly vaccination coverage statistics for children aged up to 5 years in the UK(COVER programme): January to March 2022(Published 28 June 2022)

06 July 2022

Contents
SURVEILLANCE SUMMARY .............................................................................................................................................2
INTRODUCTION .............................................................................................................................................................3
KEY INDICATORS ............................................................................................................................................................7
IHR SUMMARY ..........................................................................................................................................................7
MAP...........................................................................................................................................................................9
EPICURVES ..............................................................................................................................................................11
SUMMARY TABLE ....................................................................................................................................................22
DEMOGRAPHICS......................................................................................................................................................23
CLINICAL DESCRIPTION .............................................................................................................................................24
OUTCOME, HIV STATUS, HCW ...................................................................................................................................26
SEXUAL ORIENTATION ..............................................................................................................................................27
MICROBIOLOGICAL ANALYSES ................................................................................................................................28
DISCLAIMERS AND ACKNOWLEDGMENTS ...................................................................................................................30

1

SURVEILLANCE SUMMARY
A total of cases of monkeypox have been identified through IHR mechanisms and official publicresources up to 05 July 2022, 14:00, from 33 countries and areas throughout the European region.
Case- based data were reported for 5266 cases from 28 countries and areas to ECDC and the WHO
Regional Office for Europe through The European Surveillance System (TESSy), up to 05 July 2022,
10:00.
Of the 5266 cases reported in TESSy, 5265 were laboratory confirmed. Furthermore, where sequencing
was available, 99 were confirmed to be of the West African clade. The earliest date of symptom onset
was reported as 17 April 2022. The majority of cases were between 31 and 40 years-old (2214/5258- 42%) and male (5209/5230 - 99.6%). Among cases with known HIV status, 40% (364/917) were HIVpositive. The majority of cases presented with a rash (2684/2793 - 96.1%) and systemic symptoms suchas fever, fatigue, muscle pain, vomiting, diarrhea, chills, sore throat or headache (1931/2793 - 69%).
No cases were reported to have died. Some (15) cases were reported to be health workers, however
further investigation is ongoing to determine whether infection was due to occupational exposure.

2

INTRODUCTIONPURPOSE AND SCOPE
This report provides an overview of the total number of cases of monkeypox identified by ECDC and
the WHO Regional Office for Europe through IHR mechanisms and official public resources and casebased data through The European Surveillance System (TESSy) up to 05 July 2022.
The first summary table and maps (first two tabs) describe the number of cases identified through thedifferent platforms. The following figures and tables describe national case-based data forsurveillance of monkeypox reported in TESSy from all the countries and areas of the WHO European
Region, including the 27 countries of the European Union (EU) and the additional three countries of
the European Economic Area (EEA).
Case Report Form Data are submitted through the case-based record type MPX to The European
Surveillance System (TESSy) database hosted at ECDC.

3CASE DEFINITION (WHO)As of 24 June 2022
Cases of monkeypox should be reported to TESSy if they meet any of the WHO, ECDC or national casedefinitions.
Confirmed case
• Laboratory confirmed monkeypox virus by detection of unique sequences of viral DNA by realtime polymerase chain reaction (PCR)1 and/or sequencing.
Probable case:• A person meeting the case definition for a suspected case
AND One or more of the following:• has an epidemiological link [prolonged 2 face-to-face exposure in close proximity, including
health workers without appropriate PPE (gloves, gown, eye protection and respirator); direct
physical contact with skin or skin lesions, including sexual contact; or contact withcontaminated materials such as clothing, bedding or utensils] to a probable or confirmed
case of monkeypox in the 21 days before symptom onset;• has had multiple or anonymous sexual partners in the 21 days before symptom onset;• has detectable levels of anti-orthopoxvirus (OPXV) IgM antibody3 (during the period of 4 to 56
days after rash onset); or a four-fold rise in IgG antibody titre based on acute (up to day 5-7)
and convalescent (day 21 onwards) samples; in the absence of a recent smallpox/monkeypox
vaccination or other known exposure to OPXV;• has a positive test result for orthopoxviral infection (e.g. OPXV-specific PCR without MPXVspecific PCR or sequencing) 1.
Suspected case
• A person of any age presenting since 01 January 2022 with an unexplained acute rash or one ormore acute skin lesions
AND one or more of the following signs or symptoms:• headache, acute onset of fever (>38.5°C), lymphadenopathy (swollen lymph nodes), myalgia(muscle pain/body aches), back pain, asthenia (profound weakness)4AND for which the following common causes of acute rash or skin lesions do not fully explain
the clinical picture:• varicella zoster, herpes zoster, measles, herpes simplex, bacterial skin infections, disseminatedgonococcus infection, primary or secondary syphilis, chancroid, lymphogranuloma venereum,
granuloma inguinale, molluscum contagiosum, allergic reaction (e.g., to plants); and any otherlocally relevant common causes of papular or vesicular rash.
N.B. It is not necessary to obtain negative laboratory results for listed common causes of rash illness inorder to classify a case as suspected. Further, if suspicion of monkeypox infection is high due to either
history and/or clinical presentation or possible exposure to a case, the identification of an alternate
pathogen which causes rash illness should not preclude testing for MPXV, as coinfections have been
identified.
Discarded case
• A suspected or probable case for which laboratory testing of lesion fluid, skin specimens orcrusts by PCR and/or sequencing is negative for MPXV1.
• Conversely, a retrospectively detected probable case for which lesion testing can no longer beadequately performed (i.e., after the crusts fall off) and no other specimen is found PCR-positive,
would remain classified as a probable case.

1. PCR on a blood specimen may be unreliable and should also not be used alone as a first line
diagnostic test. If blood PCR is negative and was the only test done, this is not sufficient to discard a case that otherwise meets the definition of a suspected for probable case. This applies
regardless of whether the blood PCR was for OPXV or MPXV specific.
2. Evidence is currently lacking as to the duration of exposure necessary for infection by the
respiratory route, including how it relates to the severity of the index case’s disease.
Characterization of this parameter is one of the goals of the case investigation form describedbelow
3. Serology can be used for retrospective case classification for a probable case in specificcircumstances such as when diagnostic testing through PCR of skin lesion specimens has notbeen possible, or in the context of research with standardized data collection. The primary
diagnostic test for monkeypox diagnosis is PCR of skin lesion material or other specimen such as
an oral or nasopharyngeal swab as appropriate. Serology should not be used as a first line
diagnostic test.
5

CASE DEFINITION (ECDC)
Cases of monkeypox should be reported to TESSy if they meet any of the WHO, ECDC or national casedefinitions.
Confirmed case :• A person with a laboratory-confirmed monkeypox infection (1) monkeypox virus specific PCR
assay positive result or (2) orthopoxvirus-specific PCR assay positive result which is then confirmed by nucleotide sequence determination of the detected virus as MPXV) with symptom onset since 1 March 2022.
Probable case :(1) A person with an unexplained rash1 on any part of their body AND one or more other symptom(s)of monkeypox infection2 with symptom onset since 1 March 2022
AND one of the following:• has a positive laboratory test result on orthopoxviral infection (e.g., orthopoxvirus-specificpositive PCR without sequencing, electron microscopy, serology);• has an epidemiological link to a confirmed or probable case of monkeypox in the 21 days before
symptom onset;• reports travel to MPX endemic countries in the 21 days before symptom onset;• is a person (of any sexual orientation) who had multiple or anonymous sexual partners in the 21days before symptom onset;• is a man who has sex with men.
OR(2) A person with an unexplained generalized or localized maculopapular or vesiculopustular rashwith centrifugal spread, with lesions showing umbilication or scabbing, lymphadenopathy andone or more other MPX-compatible symptoms2.

1. Since EU/EEA countries are just starting to identify cases and if testing capacity is sufficient, theabove more sensitive case definition can be used. In countries with limited testing capacity fororthopoxviruses, the following description can be added to characterize the rash: ‘unexplained
localized or generalized maculopapular or vesiculopustular rash potentially with umbilicationor scabbing’.
2. Fever (usually higher >38.5°C), headache, back ache, fatigue, lymphadenopathy (localized or
generalized).
6

KEY INDICATORSIHR SUMMARY
Table 1: Summary of number of cases of monkeypox identified through IHR mechanisms and official public resources and reported to
TESSy, European Region, 2022
Country/Area

Number of cases identified through IHR and official public resources

Number of cases reported through TESSy

United Kingdom
Spain
Germany
FrancePortugal
Netherlands
Italy
Belgium
Switzerland
IsraelIreland
Austria
SwedenDenmark
Hungary
NorwayPolandSlovenia
Romania
Finland

1351
1256
1242
498
415
352
233
169
115
52
44
37
28
24
22
19
13
12
12
10

1228
1196
1242
350
242
285
233
169
82
0
44
28
27
24
22
19
13
9
12
0
7

Country/Area

Number of cases identified through IHR and official public resources

Number of cases reported through TESSy

Czechia
Malta
Luxembourg
GreeceIceland
Bulgaria
LatviaEstonia
SerbiaGeorgia
Croatia
Gibraltar
Türkiye

8
8
7
6
4
3
2
2
1
1
1
1
1

8
8
7
6
3
3
2
2
0
1
1
0
0

Total

5949

5266

8

MAP
ECDC Map
Figure 1a: Distribution of cases of monkeypox, European Region, TESSy, 2022, ECDC borders

9WHO-EURO Map
Figure 1b: Distribution of cases of monkeypox, European Region, TESSy, 2022, WHO EURO borders

10

EPICURVES
Date of notification is defined as the date when the case report is notified for the first time to the placeof notification, date of diagnosis is defined as the first date of clinical or laboratory diagnosis, and dateof onset as the date of onset of any symptoms.
Overall by date of notification
Figure 2: Overall number of cases of monkeypox, per date of notification, European Region, TESSy, 2022

11

Overall by date of symptom onset
Figure 3: Overall number of cases of monkeypox, per date of symptom onset, European Region,
TESSy, 2022

12

By date of onset and by country or area
Figure 4: Number of cases of monkeypox, per day and per country/area of notification, European
Region, TESSy, 2022

13

By date of onset and by country or area - country/area level
Figure 5: Number of cases of monkeypox, per day and per country/area of notification, European Region, TESSy, 2022
Austria

Belgium

60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset*

14Bulgaria

Croatia60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset*

Czechia

Denmark

60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset*

15

Estonia

France60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset*

Georgia

Germany

60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset*

16

Greece

Hungary

60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset*

Iceland

Ireland60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset*

17

ItalyLatvia60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset*

Luxembourg

Malta

60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset*

18

Netherlands

Norway60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset*

PolandPortugal60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset*

19

Romania

Slovenia

60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset*

Spain

Sweden60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset*

20

Switzerland

United Kingdom

60

Number of new cases

Number of new cases

60

40

20

0

40

20

0

Day of symptom onset*

Day of symptom onset**Day of symptom onset or earliest of day of diagnosis or notification if missing

21

SUMMARY TABLE
Table 2: Summary of number of probable and confirmed cases of monkeypox by country/area, European Region, TESSy, 2022
Country

Confirmed cases

Probable cases

Unclassified cases

Total cases

Austria
Belgium
Bulgaria
Croatia
Czechia
Denmark
Estonia
FranceGeorgia
Germany
GreeceHungary
Iceland
IrelandItaly
LatviaLuxembourg
Malta
Netherlands
NorwayPolandPortugal
Romania
Slovenia
Spain
SwedenSwitzerland
United Kingdom
Total

28
168
3
1
8
24
2
350
1
1242
6
22
3
44
233
2
7
8
285
19
13
242
12
9
1196
27
82
1228
5265

0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

28
169
3
1
8
24
2
350
1
1242
6
22
3
44
233
2
7
8
285
19
13
242
12
9
1196
27
82
1228
5266

22

DEMOGRAPHICS
Figure 6: Age and sex distribution of cases of monkeypox, European Region, TESSy, 2022

Information on sex is missing for 36 cases and information on age is missing for 8 cases.

23

CLINICAL DESCRIPTION
The average time between symptom onset and diagnosis was 7 days.
Figure 7: Distribution of symptoms among those reporting at least one type of symptom (N=2793),
European Region, TESSy, 2022

24

Table 3: Distribution of rash and systemic symptoms among those reporting at least one type ofsymptom (N=2793), European Region, TESSy, 2022
Any type of rash

Systemic Symptoms*

Count (%)

AbsentAbsentPresent
Present
Total

AbsentPresent
AbsentPresent-

13 (0.5%)
96 (3.4%)
849 (30.4%)
1835 (65.7%)2793 (100%)*Fever, fatigue, muscle pain, vomiting, diarrhea, chills, sore throat, headache
Detection of asymptomatic cases is dependent on testing guidelines which currently do not recommend
testing asymptomatic persons

25

OUTCOME, HIV STATUS, HCW
Table 4: Summary of outcome, HIV status of cases, and cases of monkeypox among health workers,
European Region, TESSy, 2022

Admitted to ICU
Hospitalized*
Died
HIV-Positive
Health worker

Yes

No

Total

1 (0.2%)100 (9.9%)
0 (0.0%)364 (39.7%)
15 (2.2%)

585 (99.8%)
913 (90.1%)
4012 (100%)
553 (60.3%)666 (97.8%)

586 (100%)
1013 (100%)4012 (100%)
917 (100%)681 (100%)*Includes cases hospitalized for isolation or treatment (19 cases were hospitalized for isolation purposes,
35 required clinical care and 46 were hospitalized for unknown reasons).

26

SEXUAL ORIENTATION
Sexual orientation in TESSy is defined according to the following non-mutually exclusive categories:• Heterosexual• MSM = MSM/homo or bisexual male
• Women who have sex with women• Bisexual• Other• Unknown or undetermined
Sexual orientation is not necessarily representative of the gender of the person the case had sex within the past 21 days nor does it imply sexual contact and sexual transmission.
We summarize here the sexual orientation that male cases identified with. No differences wereobserved across age groups.
Table 5: Summary of reported sexual orientations among cases of monkeypox, European
Region, TESSy, 2022
Sexual Orientation

Count (%)

MSM
Bisexual
Heterosexual
Unknown or undetermined
Missing
Total

1386 (26.6%)
14 (0.3%)
12 (0.2%)
852 (16.4%)2945 (56.5%)5209 (100%)27

MICROBIOLOGICAL ANALYSESSPECIMEN TYPES

Table 6: Summary of specimen types with positive test result used for diagnosis of monkeypox,
European Region, TESSy, 2022
Specimen typeCount

Lesion swab
Oropharyngeal swab
Lesion crust
Rectal swab
Genital swab
Urine
Serum
Semen
Total

126 (46.0%)
58 (21.2%)
43 (15.7%)
35 (12.8%)
11 (4.0%)
1 (0.4%)0 (0.0%)0 (0.0%)274 (100%)PHYLOGENETICS
Phylogenetics of monkeypox virus
Whole genome sequences of MPXV were extracted from GISAID EpiPox and NCBI GenBank on 4 July
2022. The phylogenetic analysis was performed using ParSNP1 with MT903344.1 as reference andvisualized using Microreact2. Further analysis was performed using NextClade information3 to verify
the quality of any highly divergent sequences.
Figure 8A shows the two genetically distinct major clades described for MPXV, the Central
African (Congo Basin) and West African clades.
The 2022 MPXV sequences from Europe are part of a distinct cluster within the West African clade(Figure 8B) and cluster together with 2022 MPXV sequences from Australia, Brazil, Canada, Mexico,
Peru, South Africa, and the US. Sequences from 2022 are indicated with coloured circles and thebinary heatmap shows new sequences uploaded to sequence databases after 27 June 2022. Two
2022 sequences from the US do not cluster with the other outbreak sequences. Available information
indicate that these are sporadic cases not linked to the current outbreak.
Limited sampling and sequencing of MPXV over the past years make it difficult to generate a hypothesison the source of introduction for this outbreak at the moment.
28

Figure 8A. Phylogenetic tree of monkeypox virus sequences as of 04 July 2022.

Figure 8B. Phylogenetic tree of monkeypox virus sequences from West African clade as of 04 July 2022.

1. Treangen TJ, Ondov BD, Koren S, Phillippy AM. The Harvest suite for rapid core-genomealignment and visualization of thousands of intraspecific microbial genomes. Genome Biology.
2014;15(524). Available at: https://genomebiology.biomedcentral.com/articles/10.1186/
s13059-014-0524-x
2. Argimón S, et al. Microreact: visualizing and sharing data for genomic epidemiology andphylogeography.
Microbial
Genomics.
2016;2(11).
Availableat:https://www.microbiologyresearch. org/content/journal/mgen/10.1099/mgen.0.000093
3. Aksamentov, I., Roemer, C., Hodcroft, E. B., & Neher, R. A., (2021). Nextclade: clade assignment,
mutation calling and quality control for viral genomes. Journal of Open Source Software, 6(67),3773, https://doi.org/10.21105/joss.03773
29

DISCLAIMERS AND ACKNOWLEDGMENTS
COPYRIGHT STATEMENT AND DISCLAIMERS
Users are advised to interpret all data with caution and be aware of their limitations. Case counts andtheir corresponding data may have weekly updates that include historical corrections as new
information is collected and reported.
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All reasonable precautions have been taken by WHO and ECDC to verify the information contained inthis publication. However, the published material is being distributed without warranty of any kind,either expressed or implied. The responsibility for the interpretation and use of the material lies withthe reader. In no event shall WHO or ECDC be liable for damages arising from its use. Copyright, permissions and referencing The WHO Regional Office for Europe is responsible for the accuracy of theRussian translation.
Suggested citation: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Monkeypox, Joint Epidemiological overview, 06 July, 2022.
Tables and figures should be referenced: European Centre for Disease Prevention and Control/WHO
Regional Office for Europe. Monkeypox, Joint Epidemiological overview, 06 July, 2022.
© World Health Organization 2022.
© European Centre for Disease Prevention and Control 2022.
Some rights reserved. This work is available under the Creative Commons Attribution- 4.0
International (CC BY-4.0 ; Creative Commons — Attribution 4.0 International — CC BY 4.0. In any
use of this work, there should be no suggestion that WHO or ECDC endorse any specificorganization, products or services. The use of the ECDC or WHO logo is not permitted. If you create atranslation of this work, you should add the following disclaimer along with the suggested citation:“This translation was not created by the European Centre for Disease Prevention and Control (ECDC)
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accuracy of this translation. The original English edition shall be the binding and authentic edition.

30

ACKNOWLEDGMENTS
We gratefully acknowledge the input of national public health staff involved in surveillance
activities and data submission to TESSy, as well as the authors from the originating laboratories
responsible for obtaining the specimens, as well as the submitting laboratories where the genome
data were generated and shared via GISAID, on which this research is based (detailed
acknowledgments available here).

31