Why health officials are expanding access to the monkeypox vaccine
The World Health Organization said the spread of the virus to children raises sobering possibility the virus could become endemic
Anyone who might have been exposed to monkeypox should now be able to receive a vaccination, according to U.S. public health officials who say the immunizations will be available across the nation at some health clinics.
Because of limited initial supply, priority is being given to those who have or might have been exposed.
The Department of Health and Human Services announced this week that nearly 300,000 doses of a new Jynneos vaccine will be made available over the summer, with 56,000 doses available immediately from the national stockpile. How doses are allocated will be determined by the number of cases in a state and the share of the state’s population at risk for severe disease.
The New York Times reported that the smallpox vaccine, ACAM2000, is associated with harsh side effects and even death. Those who are pregnant, immune-compromised or older face the greatest risk. The Jynneos vaccine has fewer side effects than the smallpox vaccine.
Initially, the new vaccine was available only in cases of confirmed exposure to monkeypox, but the Health and Human Services release said that “given the large number of contacts and difficulty in identifying all contacts during the current outbreak, the vaccine will now be provided to individuals with confirmed and presumed monkeypox exposures. This includes those who had close physical contact with someone diagnosed with monkeypox, those who know their sexual partner was diagnosed with monkeypox, and men who have sex with men who have recently had multiple sex partners in a venue where there was known to be monkeypox or in an area where monkeypox is spreading.”
“We are focused on making sure the public and health care providers are aware of the risks posed by monkeypox and that there are steps they can take — through seeking testing, vaccines and treatments — to stay healthy and stop the spread,” said the Centers for Disease Control and Prevention director, Dr. Rochelle Walensky.
The World Health Organization notes the monkeypox virus is transmitted to humans through close contact with an animal or person who has been infected or with material that has been contaminated with the virus, including bed linens and clothing. It spreads through broken skin, the respiratory tracts or the mucous membranes in the eyes, nose and mouth.
Between 3%-6% of cases are fatal, but most often, people recover on their own.
Monkeypox is similar in appearance to smallpox, but is typically less contagious and the illness is less severe, the international health agency said.
As the Deseret News previously reported, symptoms usually start with fever, headache, muscle aches and exhaustion. Unlike smallpox, lymph nodes swell with monkeypox. The period from time of infection to symptoms is typically between seven and 14 days, though it can range between five and 21 days.
After those early symptoms, a rash develops, typically on the face, then spreads, often to the chest and palms. Pus-filled lesions form, then scab and fall off. The infection may last as long as a month.
Many of the initial cases in the current international outbreak have been tied to men having sex with other men, health officials have said. But officials worldwide say others have also been infected.
“I am concerned about sustained transmission because it would suggest that the virus is establishing itself and it could move into high-risk groups including children, the immunocompromised and pregnant women,” said World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus Wednesday during a media briefing. “We are starting to see this with several children already infected.”
He called on countries to increase their surveillance by boosting testing, follow clinical guidance and engaging communities so they know the risks and how to protect themselves — an effort that asks communities to “squash the stigma around the virus.”
U.S. could lose control
Without swift, decisive action, monkeypox could become endemic in the United States, as it is in some parts of Africa, experts say.
“Many of us are concerned that the window is closing for us to be able to eliminate monkeypox,” Dr. Celine Grounder, an infectious disease expert and editor at large for Kaiser Health News, told The New York Times.
The CDC reported 351 cases in 27 states and the District of Columbia by June 29, which was more than double that of the previous week. Public health officials warn the numbers could be undercounts.
With case numbers rising, many experts fear the demand will quickly outpace the number of vaccine doses initially available.
The New York Times reported that Washington’s health department offered 300 monkeypox vaccination appointments on Monday and the slots filled within 15 minutes. New York City booked up all its available doses in less than two hours and had stopped taking walk-ins, while waiting for more vaccine doses to be available.
Europe’s similar approach
The European Health Union issued a press release this week announcing it, too, would deliver vaccines to respond to the outbreak of monkeypox, beginning with 5,300 doses of Jynneos set to arrive in Spain out of 109,090 doses it had purchased.
“This is the first time that we are, though our Health Preparedness and Response Authority, directly buying and donating vaccines to member states,” said Commissioner for Health and Food Safety Stella Kyriadkides.
The European Union doses will also be assigned based on the population of countries, with those that have a higher number of monkeypox cases being given priority. Portugal, Germany and Belgium are next in line after Spain and in July and August other countries will receive doses throughout Europe.
The agency said that since May 18, just under 2,700 cases have been reported in 23 European Union countries. This is the first time the disease has spread through Europe.