How to get a monkeypox vaccine in the United States. Who should get one?

Cases of monkeypox are increasing in the United States, and as health officials maintain the threat to the general population is low, efforts to vaccinate those at risk have begun.

The disease, which is caused by a virus and was first identified in humans in 1970, according to the World Health Organization, has generally been seen in parts of central and western Africa. Scientists think it sometimes jumped from animals, probably rodents, to humans.

Since May 2022, more than 4,100 confirmed cases of monkeypox have been reported — and one death — in 47 countries across Europe and South America, according to the Centers for Disease Control and Prevention.

In the United States, more than 240 cases of monkeypox have been reported in 26 states and the District of Columbia as of Tuesday, according to the CDC. States reporting cases include California, Florida, Illinois, Massachusetts, New York, Texas, Utah, Virginia and Washington.

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Earlier this week, the Biden administration began shipping monkeypox tests to commercial labs including Aegis Science, Labcorp and Quest Diagnostics to expand testing capabilities.

The disease, which is rare, usually begins with flu-like symptoms including fever before muscle aches, chills and fatigue. It can progress to include a rash, often on the face and genitals.

A handout photo made available by the UK Health Security Agency (UKHSA) on June 22, 2022 shows a collage of monkeypox rash lesions at an undisclosed date and location.

Monkeypox can be spread through person-to-person contact with the rash, scabs or body fluids – and by touching objects such as clothing or bedding that an infected person has used.

Most people recover from monkeypox within weeks, but the disease is fatal for up to 1 in 10 people, according to the WHO.

Who needs a monkeypox vaccine?

Those most at risk of monkeypox in this outbreak are gay, bisexual or other men who have sex with men, health officials say.

In the UK, where Britain is experiencing the largest outbreak of monkeypox beyond Africa, vaccines are now being considered for those most at risk: men who have sex with men who have multiple partners, participate in group sex, or frequent places where sex takes place on the premises. A survey of those infected in the UK found that 96% were men who were gay, bisexual or had sex with other men.

The CDC also recommends vaccinating laboratory and medical personnel — and anyone else — who may be exposed to monkeypox.

What is the Jynneos vaccine?

The Jynneos vaccine, approved in 2019 by the Food and Drug Administration for the prevention of smallpox and monkeypox in people ages 18 and older, requires two doses, four weeks apart. The CDC is also considering a measure allowing the use of the vaccine in children.

The Jynneos vaccine is considered safer than the alternatives because it is made from a virus related to smallpox and monkeypox, but it is less harmful. The research that led to its approval found that Jynneos created an immune response similar to that of the smallpox vaccine. Research data suggests the vaccine is at least 85% effective in preventing monkeypox, according to the Johns Hopkins Center for Health Security.

However, it is still unclear how well the vaccine protects humans against monkeypox. Studies in the Democratic Republic of Congo found that none of the 1,600 vaccinated healthcare workers developed monkeypox in two years, the journal Science reported. However, the research did not include a control group and one person contracted monkeypox after the study period.

The Department of Health and Human Services, within its strategic national inventory, has more than 36,000 courses from Jynneos and expects to obtain about 500,000 in total this year, according to the CDC.

“The truth is, we don’t know the effectiveness of any of these monkeypox vaccines,” Ira Longini, a biostatistician at the University of Florida who advises the WHO, told Science.

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Does the smallpox vaccine protect against monkeypox?

The United States has 100 million doses of the ACAM2000 smallpox vaccine, according to the CDC. Research from Africa suggests the vaccine is at least 85% effective in preventing monkeypox, the agency said.

However, the vaccine, which is administered by multiple punctures of a bifurcated or forked needle rather than by injection, can have some side effects, according to the FDA, including inflammation and swelling of the heart and surrounding tissues, inflammation of the brain ( encephalitis) and the spread of the virus to the rest of the body or to other people with whom they come into contact.

The vaccine is not made from the smallpox virus, but from a poxvirus similar to smallpox.

New York City offers monkeypox vaccines, other states?

The New York City health department and hospitals have administered vaccines to those who suspect they have come into contact with someone with monkeypox. The department last week opened an eligible vaccination clinic for all gay, bisexual and other men who have sex with men who have had multiple or anonymous sex partners in the past two weeks.

Other state and local agencies have also worked with the CDC on vaccinations, according to the agency.

The California Department of Public Health has requested and received vaccines from the stockpile to protect against monkeypox, the agency told USA TODAY in a statement.

Across five counties in the state, 52 cases have been reported, the agency said. “The cases primarily involved gay, bisexual and other men and transgender people who have sex with men,” the statement said. “Monkey pox is spread through close, intimate physical contact. Although the risk to the general public is very low, it is important to remember that anyone who has such contact with an infected person can contract monkey pox. People with an unusual rash or skin lesion should contact their health care provider for an evaluation.”

The CDC recommends contacting your health care provider if you have symptoms of monkeypox, even if you don’t think you’ve been in contact with someone with the disease.

This electron microscope image made available by the Centers for Disease Control and Prevention shows oval-shaped mature monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the prairie dog epidemic of 2003.

This electron microscope image made available by the Centers for Disease Control and Prevention shows oval-shaped mature monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the prairie dog epidemic of 2003.

Is there a treatment for monkeypox?

Those who catch monkeypox usually develop painful, itchy lesions, which eventually scab over and fall off. Infected people begin to experience symptoms seven to 14 days after exposure and can remain infectious for several weeks.

Vaccines for monkeypox and smallpox, when given within four days of the exposure date, the CDC says, can prevent the onset of the disease — and possibly lessen symptoms if given. up to two weeks after exposure.

However, there is currently no proven treatment for monkeypox, according to the National Institute of Allergy and Infectious Diseases. But there are several antiviral drugs used to treat smallpox and other conditions that can help patients infected with monkeypox.

The antiviral drug Tecovimat, developed to treat smallpox, has been approved for the emergency treatment of viruses such as monkeypox.

An antibody drug, Vaccinia Immune Globulin Intravenous (VIGIV), developed to treat side effects of smallpox vaccinations, and another antiviral drug, cidofovir, used to treat eye infections in AIDS patients, are also available for emergency treatment of monkeypox and similar viruses. Another antiviral drug, Brincidofovir, could potentially be used to treat the disease, and research continues on other treatments and vaccines.

Contributor: Elizabeth Weise, USA TODAY; The Associated Press

Follow Mike Snider on Twitter: @mikesnider.

This article originally appeared on USA TODAY: Monkeypox: Vaccinations for healthcare workers, those at risk offered

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