Tag: transmission

Monkeypox vaccine to be offered more widely to help control outbreak

UK Health Security Agency publishes new guidance on offering the Imvanex vaccine to men considered to be at higher risk of exposure.

A strategy published today by the UK Health Security Agency (UKHSA) recommends that some gay and bisexual men at higher risk of exposure to monkeypox should be offered vaccines to help control the recent outbreak of the virus.

Although anyone can contract monkeypox, data from the latest outbreak shows higher levels of transmission within – but not exclusive to – the sexual networks of gay, bisexual and other men who have sex with men.

The virus is not currently defined as a sexually transmitted infection, but it can be passed on by close and intimate contact that occurs during sex.

In response, the UK Health Security Agency’s (UKHSA) vaccination strategy recommends offering the smallpox vaccine Imvanex, which is shown to be effective against monkeypox, to men considered to be at higher risk of exposure.

The strategy is endorsed by the Joint Committee on Vaccination and Immunisation (JCVI), which was consulted on the eligibility criteria for the vaccine.

An individual’s eligibility would depend on a number of factors but would be similar to the criteria used to assess those eligible for HIV pre-exposure prophylaxis (PrEP) – but applied regardless of HIV status.

The strategy states that a clinician may advise vaccination for someone who, for example, has multiple partners, participates in group sex or attends ‘sex on premises’ venues.

NHS England is due to set out details on how eligible people can get vaccinated shortly. People are advised not to come forward for the vaccine until contacted.

Dr Mary Ramsay, Head of Immunisation at UKHSA, 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.

“Although most cases are mild, severe illness can occur in some people, so it is important we use the available vaccine to target groups where spread is ongoing. The NHS will soon set out details on how this will be delivered – so do not come forward for the vaccine yet.

“In the meantime, everyone should continue to be alert to any new spots, ulcers or blisters on any part of their body, particularly if they’ve had close contact with a new partner. If you think you have these symptoms, avoid close contact with others and call NHS 111 or your local sexual health centre, though please phone ahead before attending.”

Alex Sparrowhawk, Health Promotion Specialist at Terrence Higgins Trust, 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 their sexuality, to be vigilant about new spots, ulcers and blisters. We 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.”

Robbie de Santos, Director of Communications and External Affairs at Stonewall, said: “While we know anyone can catch monkeypox, we welcome the vaccine being offered to those gay and bi men who are eligible and currently at a higher risk of getting the virus.

“It is important that gay and bi men get the vaccine when offered to protect themselves and others. Let’s help get the outbreak under control so we can all have a safe and happy pride season.”

UKHSA is now publishing a regular data report on monkeypox in the UK. The report will be published every Tuesday and Friday.

Dr Sophia Makki, Incident Director at UKHSA, said: “We continue to see a steady increase in monkeypox cases. We’re reminding everyone to be aware of the symptoms of monkeypox, particularly if you’ve recently had new or multiple sexual partners, to help prevent further spread and protect others.

“If you have a rash with blisters, or any other monkeypox symptoms, don’t go to events, meet with friends or have sexual contact. Instead, stay at home and contact 111 or your local sexual health service for advice.

“Please contact the clinic ahead of your visit and avoid close contact with others until you’ve been reviewed by a clinician.”

Covid: Vaccination of Scotland’s healthcare workers offers some protection against transmission to their household contacts

A study of all healthcare workers employed by the NHS in Scotland and their households, shows that the rate of infection with Covid-19 for people that live with healthcare workers is at least 30% lower when the worker has been vaccinated mostly with a single dose.

Since household members of healthcare workers can also be infected via other people (not just via the healthcare worker they live with), this 30% relative risk reduction is an underestimate of the ‘true’ effect of vaccination on transmission.

Research led by Public Health Scotland and the University of Glasgow (with contributions from researchers at the London School of Hygiene and Tropical Medicine, Glasgow Caledonian University, the University of Edinburgh, and the University of Strathclyde) involved over 300,000 people in total and ran between 8 December 2020 and 3 March 2021.

The study, using record linkage, compared cases of Covid-19 and hospitalisations due to Covid-19 in household members of both vaccinated, and unvaccinated health care workers.

Where healthcare workers had received a second dose of the vaccine at least 14 days before, their household members had a rate of Covid-19 which was at least 54% lower than household members where healthcare workers had not been vaccinated.

While the study was not designed to examine the uptake of vaccination among healthcare workers, current work does suggest that at least some patient facing healthcare workers, particularly younger staff and those not in high exposure roles, may not have been vaccinated yet.

PHS hope that these findings would give them extra encouragement to be vaccinated, as it suggests that the vaccine offers protection not only to themselves but also to their close contacts. Any patient-facing healthcare worker who has not yet been vaccinated should contact their local health board.

Public Health Scotland will be publishing more definitive results on vaccination uptake in patient-facing healthcare workers on our daily dashboard later today (Friday 12 March).

Dr Diane Stockton, PHS Lead for COVID-19 Vaccination Surveillance Programme, said: “The results from this study as part of our vaccine effectiveness work, are very encouraging because it suggests that the vaccine helps prevent people from passing on the virus to others – something that has been suspected but hasn’t previously been shown. 

“Despite this good news, it is important to remember that infection prevention and control practices in healthcare settings remain of paramount importance, as do the mitigations to prevent spread in our daily lives. The risk of transmission did not go down to zero after the healthcare worker was vaccinated.

“As Scotland continues to deliver its national Covid-19 vaccination programme, this study does give one more reason why everyone invited to have a vaccine should take up the offer, as not only will it help protect them from COVID-19, but it will help protect the people close to them.”

Dr David McAllister, University of Glasgow said: “Our study has important implications for informing vaccination strategies. The JCVI in the United Kingdom recently commented on the lack of real-world evidence evaluating the role of vaccination programmes on transmission.

“We provide the first direct evidence that vaccinating individuals working in high-exposure settings reduces the risk to their close contacts – members of their households. Our work will also be of interest to modellers, as it can be used to inform their predictions about future rates of COVID-19 in the community.”