Who Can—And Should—Get the Monkeypox Vaccine?

With case numbers spiking in several major U.S. cities, here's who should consider getting vaccinated and when.

A close up shot of a vaccination procedure.
Photo: McKinsey Jordan / Stocksy

As new cases of monkeypox continue to appear in communities across the country, the White House has been working to ensure that vaccines are being distributed to help address the increasing case numbers.

Over the past week, the number of monkeypox vaccine doses that have been distributed throughout states and jurisdictions has more than tripled,according to the US Department of Health and Human Services (HHS). Still, the current available supply is not keeping pace with what's now surging demand and individuals who need the vaccine face challenges getting it. In New York, the system to schedule appointments for the vaccine recently crashed amid record demand and in San Francisco lines stretch around the block at facilities administering the vaccine.

At the same time, questions remain regarding who is most at risk for contracting monkeypox and who should get the vaccine. Here's a closer look at when it makes sense to consider getting vaccinated for monkeypox.

How Is Monkeypox Transmitted?

Monkeypox is not a sexually transmitted disease but the highest concentrations of infection to date have been found in the men that have sex with men population. However, the CDC points out that even if an individual did not have sexual contact with someone who is infected with monkeypox, just being in close contact with someone who has monkeypox can transmit the illness.

This means monkeypox can be transmitted through platonic skin to skin contact, Robert Amler, MD, dean and professor of public health at New York Medical College, told Health.

"This is a rash that also lands on the palms of your hands and the soles of your feet," Dr. Amler said. "For reasons that nobody's figured out, most rashes don't do that."

The virus can also be transmitted by touching surfaces if you have open lesions on your hands or feet. Dr. Amler also warned that monkeypox could be spread through common spaces like a public shower at a gym or workplace, or in public pools.

"Ninety-five percent of infections have been men having sex with men, but there's that other 5%. We want to make sure we cover all our bases," Dr. Amler said.

Who Should Get Vaccinated and When?

HHS, which has been overseeing vaccine rollout and distribution, recommends vaccination for those at high risk following a confirmed monkeypox exposure. In a June 28 press release the agency explained that "given the large number of contacts and difficulty in identifying all contacts during the current outbreak, vaccine will now be provided to individuals with confirmed and presumed monkeypox exposures."

The press release went on to explain that this includes:

  • Individuals who had close physical contact with someone diagnosed with monkeypox
  • Individuals who know their sexual partner was diagnosed with monkeypox
  • 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

The CDC's Advisory Committee on Immunization Practices (ACIP) also recommends that people whose jobs may expose them to monkeypox, get vaccinated. This could include lab personnel, research lab workers, and certain healthcare and public health response team members.

Although there have been no confirmed deaths related to monkeypox in the U.S., getting the vaccine can help mitigate the effects of the virus. When properly administered before or after a recent exposure, the vaccine can protect individuals against monkeypox illness and lessen the severity of the symptoms if administered in a timely manner, according to the CDC.

That's because unlike the COVID-19 vaccine, the monkeypox vaccine is considered a post-explore prophylaxis—meaning it can still be effective after exposure to the virus. Dr. Amler likens it to a rabies shot, which is only given when there has been known exposure.

"The fact is that the vaccine induces an immune response a bit faster than the virus itself can cause disease," Dr. Amler explained. "If the vaccine is administered early post exposure, you are in much better shape and even if you do get infected, the severity will be far less."

Those who have had contact with someone who has monkeypox or suspects they may have had contact, have four days to receive the vaccine to receive the maximum benefit, Dr. Amler added. If the vaccine is administered 4 to 14 days after exposure, it can reduce symptoms, but may not prevent the disease, according to the CDC.

Getting tested for monkeypox is also recommended for individuals who come down with any type of rash, especially one that's painful. Although the rash can appear on the hands and feet, this most recent outbreak has also seen the rash also appear in the genital or groin area, making it easy to confuse with symptoms from a few sexually transmitted diseases like herpes or syphilis. Additional signs and symptoms of monkeypox include a fever, chills, and swollen lymph nodes, according to the CDC.

Where To Get The Monkeypox Vaccine

There are two vaccines licensed by the U.S. Food and Drug Administration (FDA) for preventing monkeypox infection—Jynneos and ACAM2000.

The ACAM2000 is not advised for individuals with certain health conditions such as a weakened immune system, or skin conditions like atopic dermatitis, eczema, or pregnancy, according to the CDC. It is the Jynneos vaccine that is currently being distributed by HHS, though states and jurisdictions can also request the ACAM2000.

Access to the Jynneos vaccine is limited to people with either a known exposure or those who were alerted to a known exposure by a venue or event they recently attended. The vaccine distribution approach includes a four-tier system with top priority going to jurisdictions with the highest rate of monkeypox. Within each of those tiers, individuals with pre-existing conditions, such as HIV, will be given priority.

As part of this rollout strategy, HHS has also been working to expand access to the vaccine for prophylactic—or preventative—use in areas where there is a particularly high transmission rate.

In states and jurisdictions where the vaccine is being made available, such as in New York for example, temporary clinics are being set up where individuals can get the vaccine. Washington D.C. just announced that district residents can pre-register for vaccination appointments by visiting PreventMonkeyPox.dc.gov. The full list of states and jurisdictions that have requested vaccine supplies from HHS can be found here.

Those who obtain a vaccine are considered fully vaccinated two weeks after the second dose of Jynneos and four weeks after receiving ACAM2000. However, even fully vaccinated individuals should avoid contact with those that have an active infection, according to the CDC.

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