People at higher risk of monkeypox exposure to be offered vaccination

Some gay and bisexual men at higher risk of exposure to monkeypox will be offered the smallpox vaccine in a bid to contain the current outbreak, the UK Health Security Agency (UKHSA) has said.

Injection in front of word 'mokeypox'
(Photo: NurPhoto/Getty Images)

A new UKHSA vaccination strategy aimed at tackling the monkeypox outbreak also said that staff working in sexual health clinics who are assessing suspected cases, those looking after confirmed cases in the NHS and people working in labs that handle pox viruses should receive pre-exposure vaccination.

Latest data show that up to 20 June there have been 793 confirmed cases of monkeypox in the UK – a 38% rise in four days. Of these, 18 were in Scotland, three in Northern Ireland, six in Wales and 766 in England. The majority of cases in England (498) have been in London.

The UKHSA stressed that anyone can catch monkeypox and made clear it is not a sexually transmitted infection, however it said that 'a notable proportion of cases' had occured in men who are gay, bisexual or have sex with other men.

Vaccination strategy

The vaccination strategy, which has been backed by the Joint Committee on Vaccination and Immunisation (JCVI), would see the vaccine offered 'as soon as feasible' to men with a recent history of multiple partners, who have participated in group sex, or have attended 'sex on premises' venues. These are similar criteria as those used to identify people eligible for HIV pre-exposure prophylaxis (PrEP).

The UKHSA said that individuals could be identified when attending sexual health services. It added that NHS England would set out details shortly on how eligible people can get vaccinated and asked people not to come forward for the vaccine until they were contacted.

UKHSA's strategy also includes details on who should receive post-exposure vaccination, saying vaccination for high-risk contacts should be offered within four days of exposure.

However, this can be extended to within 14 days of exposure for those 'at ongoing risk' or those at risk of more severe complications, which includes primary school-aged children (under the age of 10 to 11), people who are pregnant and people with immunosuppression.

Monkeypox outbreak

The UKHSA is encouraging people with any new spots, ulcers or blisters on any part of their body, particularly if they’ve had close contact with a new partner, to call NHS 111 or their local sexual health centre.

UKHSA head of immunisation Dr Mary Ramsay 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.'

Alex Sparrowhawk, a health promotion specialist at Terrence Higgins Trust, welcomed the move. He 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.'

In most cases, monkeypox is a mild condition, but it can cause severe illness in some people. UKHSA guidance on vaccination issued on 21 May said that data from Africa 'suggests that previous vaccination against smallpox may be up to 85% effective in preventing monkeypox infection'. Monkeypox was made a notifiable disease earlier this month.

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