Vaccine to be offered more widely to help control monkeypox outbreak

A strategy published today by the UK Health Security Agency (UKHSA) recommends that some gay and bisexual men at higher risk of exposure to monkeypox should be offered vaccines to help control the recent outbreak of the virus.

Although anyone can contract monkeypox, data from the latest outbreak shows higher levels of transmission within, but not exclusive to, the sexual networks of gay, bisexual and other men who have sex with men.

The virus is not currently defined as a sexually transmitted infection, but it can be passed on by close and intimate contact that occurs during sex.

In response, UKHSA’s vaccination strategy recommends offering the smallpox vaccine Imvanex, which is shown to be effective against monkeypox, to men considered to be at higher risk of exposure.

The strategy is endorsed by the Joint Committee on Vaccination and Immunisation (JCVI), which was consulted on the eligibility criteria for the vaccine.

An individual’s eligibility would depend on a number of factors but would be similar to the criteria used to assess those eligible for HIV pre-exposure prophylaxis (PrEP) but applied regardless of HIV status.

The strategy states that a clinician may advise vaccination for someone who, for example, has multiple partners, participates in group sex or attends ‘sex on premises’ venues.

NHS England is due to set out details on how eligible people can get vaccinated shortly. People are advised not to come forward for the vaccine until contacted

Dr Mary Ramsay, Head of Immunisation at UKHSA, said: “Our extensive contact tracing work has helped to limit the spread of the monkeypox virus, but we are continuing to see a notable proportion of cases in gay, bisexual and other men who have sex with men. By expanding the vaccine offer to those at higher risk, we hope to break chains of transmission and help contain the outbreak.

“Although most cases are mild, severe illness can occur in some people, so it is important we use the available vaccine to target groups where spread is ongoing. The NHS will soon set out details on how this will be delivered – so do not come forward for the vaccine yet.

“In the meantime, everyone should continue to be alert to any new spots, ulcers or blisters on any part of their body, particularly if they’ve had close contact with a new partner. If you think you have these symptoms, avoid close contact with others and call NHS 111 or your local sexual health centre, though please phone ahead before attending.”

Alex Sparrowhawk, Health Promotion Specialist at Terrence Higgins Trust, said:

“This targeted vaccination programme is a positive move forward while the data still shows monkeypox is disproportionately affecting gay and bisexual men in the UK.

“We encourage everyone, regardless of your sexuality, to be vigilant about new spots, ulcers and blisters, and are continuing to closely monitor the latest data in order to play our part in providing the latest guidance and health information on monkeypox to empower the communities most affected to best protect their health.”

Robbie de Santos, Director of Communications and External Affairs at Stonewall said:

“While we know anyone can catch monkeypox, we welcome the vaccine being offered to those gay and bi men who are eligible, who are currently at a higher risk of getting the virus.

“It is important that gay and bi men get the vaccine when offered to protect themselves and others. Let’s help get the outbreak under control so we can all have a safe and happy pride season.”

ENDS.

Background

- The vaccine is already offered pre-exposure to healthcare workers due to care for patients with suspected or confirmed monkeypox in HCID units and sexual health centres, and for staff regularly undertaking environmental decontamination.

The updated strategy also extends the pre-exposure vaccine offer to the following groups at occupational risk of exposure:

• Staff in additional hospitals outside high consequence infectious disease (HCID) units designated to care for monkeypox patients
• Workers in laboratories where pox viruses are being handled

The vaccine is also currently offered to higher category close contacts of confirmed cases, ideally within four days of exposure, though this can be extended to 14 days for those at higher risk.

- Click to view the full text of the UKHSA's vaccine strategy.