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.

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-19 safety in schools: masks to stay for now

Existing COVID-19 safety mitigations in schools are to remain for now, following advice from senior clinicians. Pupils will continue to be required to wear face coverings in secondary school classrooms as they begin to return from the October break.

Secondary-aged pupils, and staff in primary and secondary schools, will also still require face coverings in communal areas or when moving around the building. 

The Chief Medical Officer has advised that while there are encouraging signs, a more cautious approach would allow more time for 12 to 15-year-olds to take up the vaccination.

Confirming that school mitigations will remain in place for now, Education Secretary Shirley-Anne Somerville also urged continued vigilance to protect pupils and staff.

Ms Somerville said: “In recent weeks we have seen the previous sharp decline in COVID-19 case numbers starting to level off, and that is why we have decided to adopt a cautious approach and maintain safety mitigations in school for the time-being.

“Progress with vaccinating 12-15 year olds has been remarkable and is already over 40%. However, this was only rolled out a few weeks ago and allowing further time will mean that that encouraging figure rises even higher.

“This decision is based on advice from senior clinicians and takes account of the most recent data. We will continue to monitor case rates on a weekly basis, with a view to lifting restrictions at earliest possible time. 

“While I fully understand that this will be disappointing news for some young people and their parents, as has been the situation throughout, the safety of children, young people, and all education staff, remains the overriding priority. There is no room for complacency and we must all continue to remain vigilant to reduce the spread of COVID-19.”

The EIS has welcomed the announcement by the Scottish Government that current school Covid safety mitigations are to be retained.

EIS General Secretary Larry Flanagan said, “The EIS has argued for great caution in any easing of school mitigations, especially in light of continuing high levels of infection and the incomplete roll out of vaccinations for pupils.”

“The priority is to keep schools open but as safe as possible, so this delay from the Scottish Government, with regard to easing mitigations, is welcome and will allow, also, more time for ventilation challenges to be met ahead of winter.” 

Yesterday’s Scottish Government announcement means that pupils will continue to be required to wear face coverings in secondary school classrooms as they return from the October break.

Secondary-aged pupils, and staff in primary and secondary schools, will also still require face coverings in communal areas or when moving around the building.

Reducing Risks in Schools Guidance