Gay men, especially those with multiple partners or who have participated in group sex, will be the main target in the UK’s monkeypox vaccination campaign, the Health Security Agency (UKHSA) said.
The Joint Committee on Vaccination and Immunisation (JCVI) has recommended that GBMSM be offered smallpox vaccines “as soon as feasible,” given they are “at highest risk due to a large number of contacts,” the UKHSA said.
There are currently no monkeypox vaccines licensed in the UK or Europe, but vaccines developed for smallpox are considered to provide cross-protection against monkeypox as the two viruses are related. The vaccine that is being offered in the UK, smallpox Modified Vaccinia Ankara–Bavarian Nordic (MVA-BN), was licensed for smallpox in the UK and Europe but was also licensed for monkeypox in the United States under a different brand name.
The JCVI said those at higher risk among the GBMSM can be identified using markers of high-risk behaviour such as “a recent history of multiple partners, participating in group sex, attending sex on premises venues,” or a proxy marker such as recent sexually transmitted bacterial infection in the past year.
The other prioritised groups are health and laboratory workers who are more likely to be exposed to monkeypox virus or other pox viruses.
The document said pre-exposure vaccination should be prioritised as there is “very limited evidence” on whether the vaccine given after exposure can make any difference, but it also recommended rapid post-exposure vaccination for “those who are at higher risk of the complications of monkeypox” including pregnant women, the immunosuppressed, and children under the age of 10 to 11.
Monkeypox is a disease mostly associated with West or Central Africa. According to UKHSA, there have been seven cases in the UK between 2018 and 2021, but the current outbreak is the first time that chains of transmission have been reported in Europe without known epidemiological links to West or Central Africa.
The first case in the UK was detected on May 7, with two unconnected incidents confirmed soon after. By Monday, there have been 793 laboratory-confirmed cases in the UK—18 in Scotland, three in Northern Ireland, six in Wales, and 766 in England.
Almost 80 percent of cases in England are located in London.
According to the UKHSA, among those whose gender information was available, 99 percent of the UK’s confirmed cases identified themselves as male, with five cases identifying themselves as female. It’s not clear whether any transgender patients were involved.
No recovery or death has been reported so far. UKHSA has said while severe illness can occur in some people, monkeypox is usually a mild self-limiting illness and most people recover within a few weeks.
