Update on vaccination to protect against Monkeypox in England

Latest figures confirm that over 25,000 people have been vaccinated with the smallpox vaccine, as part of the strategy to contain the monkeypox outbreak in the UK. These thousands of vaccines, administered by the NHS to those at highest risk of exposure, should have a significant impact on the transmission of the virus.

While anyone can get monkeypox, cases in the UK are predominantly in gay, bisexual and other men who have sex with men (GBMSM), with the virus being passed on in closely connected sexual networks, and so the smallpox vaccine is being prioritised for those men at higher risk of getting the virus, as well as some contacts of cases and some healthcare professionals.

As of 10 August, around 27,000 people have been vaccinated by the NHS and in sexual health services in England, including 25,325 GBMSM. The remainder are those who have received the vaccine as part of the healthcare worker programme, and contacts of cases.

UKHSA has secured one of the highest number of doses in the world to manage the current outbreak, procuring 150,000 doses for the UK from the global manufacturer of smallpox vaccines.  The initial delivery of around 50,000 doses – the maximum amount immediately available – has been rolled out at pace to provide as much protection to as many eligible people as possible.

There are global issues with supply due to vaccine availability and the necessary time to produce more vaccines. This means the further batch of 100,000 doses, which are being made to order, will be received later in September. UKHSA is working with the manufacturer to expedite delivery as early as possible.

Out of the just over 50,000 doses that have arrived, about 40,000 have been made available to the NHS in England for distribution as part of the pre-exposure programme for GBMSM, for contacts of cases and for some healthcare workers. Around 6,000 have been allocated to Scotland, Wales, Northern Ireland and the Crown Dependencies.

By the end of next week, UKHSA will have allocated all of the remaining stock (around 5000 doses as of 11 August) that is currently in the country to the NHS. At the same current rapid rate of delivery in NHS services, the majority of these doses will have been delivered to those identified to be at higher risk by the end of the month.

Until the delivery of further doses in September, the NHS and local partners will continue to vaccinate in line with any residual supplies, and to ensure that those who are not already in touch with services know where and how to access vaccination. Sexual health services will keep a record of those eligible so that they can be invited forward for vaccination as soon as new supply becomes available. UKHSA will continue to work with partners including Terrence Higgins Trust, and a wide range of other partners, to ensure people in the GBMSM community know the signs and symptoms of Monkeypox, and how to seek help if they have concerns and how to access vaccination.

If you think you may be eligible for a vaccination, please wait to be invited by the NHS.

Latest case figures show that the outbreak is beginning to slow with 3,017 cases in total across the UK; latest data shows 29 cases a day now confirmed on average (1 – 7 August), compared to 52 cases a day during the last week in June. Whilst this is a positive sign, ongoing vigilance is urged, given it’s too soon to determine if this slowing will be sustained.

Dr Jenny Harries, Chief Executive of UKHSA, said:

“The most important way to protect those who are more likely to get monkeypox and to limit the outbreak is to ensure that all the vaccines available to us are in people’s arms as quickly as possible and are building protection across the community.

“I’d like to thank all those who have isolated as part of this outbreak in order to limit transmission of the virus, the thousands of people who have come forward for vaccination and all those in the NHS and sexual health services who have ensured the rapid delivery of the available vaccine – this has strengthened our response to the current outbreak and should interrupt chains of transmission.”

Jim McManus, President of The Association of Directors of Public Health, said:

“Directors of Public Health are playing our part in efforts to deliver the vaccine to those who need it and we will continue to do so as long as stocks are available.  We are also working with UKHSA and a range of partners nationally to help ensure that when more doses arrive, we will be able to deliver them as quickly, fairly and efficiently as possible. 

“In the meantime, it is vitally important that gay and bisexual men continue to access sexual health services, who are working incredibly hard to respond to the current outbreak of monkeypox alongside offering their usual services.”

Dr Claire Dewsnap, BASHH President, said:

“It’s fantastic that thousands of vaccines have been delivered, we thank individuals in at risk communities for stepping up to be vaccinated and services making huge efforts to get vaccine out. We have been advised that the next currently planned delivery of vaccine won’t be available until late September. BASHH are concerned about the time it will take to receive more vaccines and will continue to work hard with national agencies to make sure the next round of delivery is as smooth as possible.”

While you are waiting for your vaccine, or if you have just received one, please remain alert to the symptoms of monkeypox, especially if you have had a new or multiple sexual partners. Symptoms can take up to 3 weeks to develop, so keep checking yourself after intimate contact with others. If you feel unwell, please speak to a sexual health service.

If you are a contact of a case – whether you have been notified by a health protection team or directly by a previous partner - please take a break from sex and intimate contact.

No vaccine is 100% effective. While the vaccine may not always prevent an individual getting monkeypox, the symptoms experienced are likely to be milder. The first dose prepares your immune system so it can respond much more quickly if you come into contact with monkeypox.

The vaccine also takes time to work. Protection will start to build after a few days and should reach highest levels after about 4 weeks.  

Common signs and symptoms of monkeypox infection include fever, headache, muscle aches, exhaustion, swollen lymph nodes, and development of a new rash. This could be a single blister like spot (or a small number) on the genitals, anus and surrounding area, lesions in the mouth, and symptoms of proctitis (anal or rectal pain or bleeding).

In July, UKHSA guidance for close contacts of a confirmed monkeypox case was updated. Based on the growing evidence of how the monkeypox virus is being passed on in this outbreak, most close contacts no longer have to isolate for 21 days unless they develop symptoms.