Category: Monkey Pox Vaccine

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There’s a Monkeypox Vaccine. But Not Everyone May Need It | Time

August 13, 2022

Case counts of monkeypox continue to grow worldwide, raising concerns about how people can protect themselves. So far, the World Health Organization reports that in 12 countries, 92 cases have been confirmed in this recent emergence of the virus, and 28 possible cases are still being investigated. What alarms public health officials about the recent outbreaks is that monkeypox is generally not common or known to circulate in these nations; its endemic in parts of central and western Africa, but not in the European and North American nationsincluding the U.S.that are currently seeing an uptick in infections. The U.S. recorded its first case this year in Massachusetts on May 18, and officials from the U.S. Centers for Disease Control and Prevention (CDC) said in a briefing on May 23 that the agency is working with state health departments in New York, Florida, and Utah to investigate four additional potential cases.

The good news is that an approved, effective, and relatively new monkeypox vaccine already exists. But do Americans need to get vaccinated?

Made by the Danish company Bavarian Nordic and named Jynneos, the vaccine uses a live version of the smallpox virus that has been engineered so that it cannot replicate in the body or cause infection, but can still activate the immune system to mount defenses against both the smallpox and monkeypox viruses to protect people from getting infected. According to studies conducted among people who were vaccinated in Africa, where the virus has circulated for years, two doses of the vaccine, given 28 days apart, were up to 85% effective in protecting people from getting monkeypox. It was approved by the U.S. Food and Drug Administration (FDA) in 2019 to protect against both smallpox and monkeypox.

Americans dont routinely get vaccinated against either disease. But in November 2021, the Advisory Committee on Immunization Practices (ACIP) within the CDC considered the question of who should be immunized against monkeypox, since cases in the U.S. have occurred after people traveled to areas in Africa where the disease is endemic. After analyzing the available studies, the ACIP recommended that those at highest risk of exposure and infectionincluding scientists who work in labs that study monkeypox virus, first responders who may treat those occupational cases, and health care workers who care for infected patientsshould receive the vaccine. The recommendations were accepted by CDC director Dr. Rochelle Walensky and published in the agencys publication of record, the MMWR, on May 27, making them official.

The ACIP did a very good job of considering all the different populations who might have occupational risks of exposure [to monkeypox], says Brett Peterson, deputy chief of the pox virus and rabies branch of the CDC. But, he says, that was before the current clusters of cases, and the committee members focused primarily on how best to protect people at high occupational risk from getting infected, since there wasnt a significant danger of cases in the wider population. The recommendations did not address potential community cases of monkeypox, and whether people other than those at high occupational risk of exposure should get vaccinated. But if cases continue to emerge, the agency may review the data and address that need if it becomes relevant.

Unlike with the COVID-19 vaccines, immunizing people against monkeypox likely wont involve a mass campaign, because monkeypox isnt as contagious or as easily spread as SARS-CoV-2. Monkeypox was discovered in 1958 and named after the colonies of monkeys, which were part of research studies, in which the virus was first identified. In recent years, human cases have been reported primarily in central and West African countries such as Nigeria and Cameroon, with the West African virus, which circulates widely in Nigeria, resulting in less severe disease than the central African version. As a poxvirus, its symptoms are similar to those of smallpox, and include fever, muscle aches, and headache. Unlike smallpox, however, monkeypox also causes the lymph nodes to swell, and several days after the initial fever, hallmark lesions start appearing throughout the body, eventually developing into larger fluid-filled vesicles and pustules before forming scabs. Most people with the disease recover without treatments after two to four weeks, although antiviral therapies could be helpful, especially for those with weakened immune systems. In the May 23 press briefing, CDC scientists noted that the data showing the efficacy of these antiviral treatments in human patients are still limited, and that most of the data supporting their use come from animal studies.

The virus can spread through a number of routes, the most common and direct being via breaks in the skin or contact with body fluids. Monkeypox and also transmit from one person to another through respiratory droplets from sneezes or salivaalthough infection is less likely to occur this way and more likely to happen with direct contact with the virus-laden lesions.

Thats why vaccinating for monkeypox will most likely involve a version of what experts call a ring strategy, and focus on immunizing only those with contact with infected individuals. If a case is reported in the country, a public health SWAT team goes out, finds out who the close contacts are of that first case, and vaccinates just those close contacts, and not the entire city or suburb, says Dr. David Freedman, professor emeritus of infectious diseases at the University of Alabama at Birmingham and president-elect of the American Society of Tropical Medicine and Hygiene. Because monkeypox is not a virus that is spread mainly through respiratory transmission, you dont see huge numbers of infected people. So you can do ring vaccination around the known cases.

If that approach is used, we have sufficient vaccine in the Strategic National Stockpile to vaccinate the entire U.S. population, says Peterson. I am confident that there is sufficient vaccine available for use in this situation. The U.S.s initial contract with Bavarian Nordic after the vaccine was approved called for 28 million doses of the vaccine to be provided for the stockpile over a number of years. But because some of those doses were delivered around 2019, some have expired, and the terms of the agreement require the company to replace expired doses with freshly manufactured ones.

Captain Jennifer McQuiston, deputy director of the division of high consequence pathogens and pathology at CDC, said during the press briefing that about 1,000 doses of the vaccine are currently available, and that Bavarian Nordic expects to ramp up production to increase that supply. In addition, on May 18, the U.S.s Biomedical Advanced Research and Development Authority (BARDA), part of the Department of Health and Human Services, called in an existing order for up to 13 million additional frozen doses to add to that stockpile. The versions of the vaccine currently in storage were manufactured as a liquid and then frozen, which gives them a shorter shelf life, according to Peterson. The newer, freeze-dried versions are first turned into a powder that makes them more resistant to changes in temperature before they are reconstituted just before being injected. But these more shelf-stable vaccines wont be available until 2023 and 2024.

McQuiston added that so far, officials at the Massachusetts Department of Health have identified more than 200 close contacts of the only confirmed monkeypox case in the U.S.most of whom are health care workersand that some of those contacts have been vaccinated with doses from the national stockpile.

That stockpile also contains doses of a different, older smallpox vaccine, which has not been reviewed or approved by the FDA specifically for monkeypox, but could also be used to protect people against the latter disease, since the viruses are related and the shots can generate immunity that can cross react with both viruses. This vaccine, called ACAM2000, has been approved in the U.S., Australia, and Singapore to protect against smallpox but can cause side effects including inflammation of heart tissues, and it is not recommended for people with weakened immune systems. Unlike Jynneos, ACAM2000 is built around a disabled monkeypox virus that is still able to replicate, although it cant cause disease. Jynneos was developed specifically to offer those with compromised immune systems an option for getting vaccinated against smallpox, but its safer profile led the FDA to approve it for the general population as well. The vaccines ability to cross-react and generate immune protection against monkeypox made it doubly useful. Its important to know that Jynneos can be given to people without needing a detailed health screening, says Freedman.

There isnt strong enough evidence yet to suggest where and how the recent outbreaks began, but the clusters in Europe involve men who have sex with men, and many of these global reports of monkeypox cases are occurring within sexual networks, said Dr. Inger Damon, a poxvirus expert with the CDC, in a statement on the agencys website.

The first genetic analysis of the monkeypox viruses from the recent cases suggests that they originated in Nigeria, where one of two common versions of the virus are endemic, and were brought to other parts of the world via infected travelers. But researchers will continue to analyze the genetic data further to understand if and how the latest clusters of cases are related.

In the meantime, should the outbreak grow significantly in scale and scope enough to warrant immunization, health experts in the U.S. are confident that there will be enough doses of the shot to be distributed to Americans who might need them.

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There's a Monkeypox Vaccine. But Not Everyone May Need It | Time

Monkeypox Vaccine | San Francisco

August 13, 2022

As supply dictates, the Monkeypox vaccine is available by appointment at clinics throughout the city, including Kaiser Permanente and UCSF. See sites below.

The walk-in vaccination clinic located at ZSFG at 1001 Potrero, Building 30, is open through Friday, August 12 from 8am noon. Additionally, the clinic will be open on Saturday, August 13 from 8am 3:30pm. No appointment is needed.

Kaiser Permanente will have a walk-in vaccination clinic for patients and non-patients on Saturday, August 13 from 9am 2pm at the Kaiser Permanente San Francisco Medical Center at 2675 Geary Boulevard.

Medical providers Kaiser and UCSF will be providing doses via appointments and will serve both non-patients and patients. Please check their websites for appointments or call your provider for more information.

DPH is working with local community-based organizations to provide the vaccine to those who may not have access to thewalk-inclinic or a healthcare provider.We will continue to keep the community updated onadditionalallocations of vaccines and access points.

To date, we have receivedapproximately23,000 doses from the federal stockpile from the California Department of Public Health (CDPH). SFDPH requested 35,000 doses to begin to meet the need.

This, unfortunately, means that someone may be eligible for a vaccine but unable to receive it immediately due to a lack of vaccine supply from the State and Federal governments.

The goal is for everyone who wantsa vaccine to receive a vaccine.

We will let the community know as soon as we have more doses of the vaccine.

People who live and work in San Francisco are eligible for aJynneos vaccine:

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Monkeypox Vaccine | San Francisco

U.S. Orders 2.5 Million More Monkeypox Vaccine Doses, as CDC Looks to …

August 13, 2022

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The Biden administration today said it ordered 2.5 million more doses of Bavarian Nordics Jynneos monkeypox vaccine, bringing the total vaccine doses to be delivered in 2022 and 2023 to more than 4 million.

The news followed Tuesdays announcement of the first phase of the U.S. governments national monkey vaccine strategy, which will expand testing capabilities and make Bavarian Nordics Jynneos vaccines readily available to anyone exposed to the virus.

The U.S. Department of Health and Human Services (HHS) said the governments enhanced nationwide strategy will vaccinate and protect those at-risk of monkeypox, as well as provide guidance to communities on how to respond to outbreaks.

We are focused on making sure the public and healthcare providers are aware of the risks posed by monkeypox and that there are steps they can take through seeking testing, vaccines and treatments to stay healthy and stop the spread, said Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC).

As part of the strategy, the CDC and HHS began shipping tests to five major laboratory companies across the country: Aegis Science, Labcorp, Mayo Clinic Laboratories, Quest Diagnostics and Sonic Healthcare.

The government, which for months has been buying more Jynneos doses to add to the national stockpile, is now distributing the vaccine. Its currently making available 296,000 doses and expects to roll out 750,000 doses over the summer, with an additional 500,000 doses produced and released in the fall for a total of 1.6 million doses this year.

The Jynneos vaccine is licensed for use in adults and is considered safer than Emergent BioSolutions Inc.s ACAM2000 smallpox vaccine, which also can be used against monkeypox, the HHS said.

The vaccine will be made available to individuals with confirmed and presumed monkeypox exposures, said the HHS.

This includes those who had close physical contact with someone diagnosed with monkeypox, those who know their sexual partner was diagnosed with monkeypox, and 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.

Health officials seeking to expand use of monkeypox vaccine for kids, despite lack of safety data

U.S. health officials also are seeking to expand use of the monkeypox vaccine for children, Bloomberg reported.

The CDC is developing a protocol aimed at allowing use of the Jynneos vaccine in children should cases in children occur, Kristen Nordlund, a CDC spokesperson, said in an email to Bloomberg.

Im concerned about sustained transmission because it would suggest that the virus is establishing itself, and it could move into high-risk groups, including children, the immunocompromised, and pregnant women, Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO) said in a Wednesday press briefing.

Were starting to see this with several children already infected, he added.

There have been 350 cases so far of monkeypox in the U.S. all adults according to the CDC. The agency confirmed 5,115 cases worldwide.

The WHO confirmed two cases in children in the U.K. and said Wednesday it is following up on reports of cases in children in Spain and France.

No safety trials have been done in children for the Jynneos vaccine as of yet, partly because clinical research involving participants under the age of 18 must pose no more than minimal risk to children, which can be difficult for vaccine manufacturers to argue.

Commenting on the CDCs actions, Dr. Meryl Nass, a member of the Childrens Health Defense scientific advisory committee, told The Defender, Its kind of extraordinary that they want to vaccinate everyone in the country before knowing what the safety issues are.

Nass, an internist and biological warfare epidemiologist, said, We dont actually know if the Jynneos vaccine prevents monkeypox in humans because it was developed as a smallpox vaccine, and prevention studies have been conducted using only animals.

It is hard to believe that the [U.S. Food and Drug Administration (FDA)] gave this vaccine a license when you read the FDA reviewers comments in their own report, Nass wrote in her June 23 substack newsletter.

They could not test the vaccine for efficacy against smallpox because there is no smallpox, nor against monkeypox, because the disease is so rare, Nass wrote. So the FDA relied on neutralizing antibody titers.

At the same time, the FDA admitted there is no established correlate of protection, Nass said.

This means that there is no evidence that the titers represent actual immunity to infection, Nass wrote. So FDA relied on animal studies to simply guess the vaccine might be effective in humans.

According to the FDA, the effectiveness of Jynneos for the prevention of monkeypox is inferred from the antibody responses in the smallpox clinical study participants and from studies in non-human primates that showed protection of animals vaccinated with Jynneos who were exposed to the monkeypox virus.

Jynneos, a replication-deficient live Vaccinia virus vaccine, was licensed in the U.S. in 2019, by the FDA for use in individuals 18 and over considered to be at high risk for smallpox or monkeypox.

In 2021, the CDCs Advisory Committee on Immunization Practices (ACIP) voted to recommend Jynneos as a safer alternative to the ACAM2000 vaccine because of ACAM2000s propensity to cause serious adverse effects, including myocarditis and pericarditis i.e., inflammation of the heart.

However, Nass noted, Jynneos also was linked to heart inflammation, according to the FDA licensure review of the Jynneos smallpox-monkeypox vaccine which reported:

Up to 18.4% of subjects in 2 studies developed post-vaccination elevation of troponin [a cardiac muscle enzyme signifying cardiac damage]. However, all of these troponin elevations were asymptomatic and without a clinically associated event or other sign of myopericarditis.

These higher levels of troponin were not studied further, and the reviewers admitted they did not know if the Jynneos vaccine caused myocarditis, Nass said.

The Jynneos manufacturers said they would conduct an observational, post-marketing study in which they would collect data on cardiac events that occur and are assessed as a routine part of medical care.

But myocarditis particularly asymptomatic forms of myocarditis that lack outer signs of the condition could fly under the radar of the routine part of medical care, noted Nass.

The manufacturers would need to test for heightened troponin levels something that is not typically done in routine check-ups.

The authors of a 2015 study reported evidence of heart injury following vaccination in a sample of 1,445 individuals who received a smallpox or trivalent influenza vaccine.

They found that chest pain, shortness of breath and/or palpitations occurred in 10.6% of those who received the smallpox vaccine SPX-vaccinees and 2.6% of those who received the trivalent influenza vaccine within 30 days of immunization.

Additionally, the study authors reported levels more than double the upper limit of troponin a protein that flags cardiac injury in 31 of the individuals who received the smallpox vaccine.

Passive surveillance significantly underestimates the true incidence of myocarditis/pericarditis after smallpox immunization, they concluded.

The authors added:

Evidence of subclinical transient cardiac muscle injury post-vaccine immunization is a finding that requires further study to include long-term outcomes surveillance. Active safety surveillance is needed to identify adverse events that are not well understood or previously recognized.

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U.S. Orders 2.5 Million More Monkeypox Vaccine Doses, as CDC Looks to ...

Why the federal government is sending monkeypox vaccine to Utah

August 13, 2022

Some 500 doses of monkeypox vaccine are headed to Utah, where five cases of the virus have now been reported.

Utah is one of 32 states and jurisdictions as of Tuesday that had requested the smallpox vaccine deemed effective in treating and preventing monkeypox. The vaccine is being distributed as part of the Biden administrations response to the global outbreak of the virus that now includes five cases in Utah.

Three cases have been identified in Salt Lake County, but the Centers for Disease Control and Prevention updated Utahs case count to five on Wednesday afternoon. One of the new cases is in Utah County and the other is in Salt Lake County, according to Utah Department of Health spokeswoman Charla Haley.

The latest Salt Lake County case was reported Wednesday afternoon and has yet to be confirmed by the CDC, Salt Lake County Health Department spokesman Nicholas Rupp said. The Salt Lake County resident became infected while traveling, is in isolation and does not present a risk to the public. Contact tracing is underway, Rupp said.

The Salt Lake County Health Department is already working on a distribution plan to get the vaccine to those considered at high risk for monkeypox, currently primarily men who have sex with men, but is still waiting to hear how many doses will be available and when theyll arrive, Rupp said.

Neither the three people confirmed to have monkeypox in Salt Lake County nor anyone they came in contact with needs the vaccine, Rupp said. The two Salt Lake County men who became Utahs first cases in May after a European trip have recovered, and he said the states third case, also a county resident, is doing good.

The four infected people in Salt Lake County agreed to voluntarily isolate, Rupp said, until they were fully healed from the effects of the virus, which often starts with a rash that turns into fluid-filled pustules that scab over then eventually fall off. Besides prolonged close contact, monkeypox can also be spread through bedding and other materials.

Haley said the CDC initially agreed to send the state 20 doses of the smallpox vaccine thats being released from the nations strategic stockpile. Later, she said the federal agency, which was scheduled Wednesday to discuss future doses, was sending about 500 doses.

The White House announced plans Tuesday to provide the Jynneos vaccine nationwide to individuals at high risk to mitigate the spread of monkeypox, a disease that had largely been confined to parts of Africa until the latest outbreak.

So far, more than 9,000 doses of vaccine, along with 300 courses of antiviral smallpox treatments, have been deployed and another 296,000 doses will be allocated over the coming weeks, including 56,000 immediately, the administration said, promising a total of 1.6 million additional doses will become available.

Because smallpox was eradicated and routine vaccination ended in the United States in 1972, the vaccine has been stored by the federal government. Utah and other states that dont have a share of the nations smallpox vaccine stockpile would have to wait up to 72 hours for doses to be transferred by the federal government.

Public health officials have said that would still be enough time to make a difference, since it is believed smallpox vaccine administered within four days of exposure to monkeypox provides protection against developing the disease, and within 14 days, may reduce its severity.

There are at least 351 monkeypox cases confirmed in the United States, and more than 5,100 worldwide, according to the CDC.

Excerpt from:

Why the federal government is sending monkeypox vaccine to Utah

Monkeypox vaccine to be offered through Fulton County nonprofit – FOX 5 Atlanta

August 13, 2022

ATLANTA - A Fulton County non-profit is helping to step up the distribution of monkeypox vaccines.

A Vision 4 Hope will begin offering 200 appointments per week beginning on Friday, August 12. Testing and vaccinations are available by appointment only.

The appointments are from noon until 6 p.m. at A Vision 4 Hope located at 1800 Phoenix Blvd, in College Park.

Those interested can call between 9 a.m. and 5 p.m. to get an appointment. The number is 678-705-3814.

Insurance is accepted for testing lab fees. Sliding scale is available for the uninsured.Vaccines are free but currently only available to high-risk populations - men who have sex with men, transwomen and sex workers.

AV4H, a safe haven for members of the LGBTQ community, also offers co-located job training, housing, counseling, mobile HIV prevention and testing, COVID testing and vaccines.

MONKEYPOX: WHAT YOU SHOULD KNOW AS U.S. DECLARES PUBLIC HEALTH EMERGENCY

The Centers for Disease Control and Prevent said as of Thursday, Georgia is now the ranked fourth in total number of monkeypox and orthopoxvirus cases at just over 800. Nearly 11,000 cases have been reported nationwide.

Most monkeypox patients experience only fever, body aches, chills and fatigue. People with more serious illness may develop a rash and lesions on the face and hands that can spread to other parts of the body.

A vile of Monkeypox virus vaccine at St. John's Well Child & Family Center on Wednesday, Aug. 10, 2022 in Los Angeles, CA. (Irfan Khan / Los Angeles Times via Getty Images)

The disease can be spread through close, personal, skin-to-skin contact including direct contact with rashes or sores, contact with objects or fabric that have been used by someone with monkeypox, or respiratory droplets or oral fluids.

There have been no U.S. deaths and officials say the risk to the American public is low. But they are taking steps to assure people that medical measures are in place to deal with the growing problem.

GEORGIA HEALTH OFFICIALS ADDRESS CONFUSION OVER MONKEYPOX TESTING

A two-dose vaccine, Jynneos, is approved for monkeypox in the U.S. The government has many more doses of an older smallpox vaccine ACAM2000 that they say could also be used, but that vaccine is considered to have a greater risk of side effects and is not recommended for people who have HIV. So its the Jynneos vaccine that officials have been trying to use as a primary weapon against the monkeypox outbreak.

Anyone with a rash that looks like monkeypox should talk to their healthcare provider, even if you do not believe you have had contact with anyone who has contracted the virus.

The Associated Press contributed to this report.

Excerpt from:

Monkeypox vaccine to be offered through Fulton County nonprofit - FOX 5 Atlanta

Plans to distribute the monkeypox vaccine in the St. Louis area – KSDK.com

August 13, 2022

DHSS distributed 1,900 vials of the vaccine to the St. Louis County health department to use in the region and to distribute to other areas of the state.

ST. LOUIS COUNTY, Mo. Health officials in the St. Louis area have announced a plan to distribute the monkeypox vaccinefor those who are eligible.

The Missouri Department of Health and Senior Services (DHSS) has designated the St. Louis County Department of Public Health as the regions vaccine hub for the City of St. Louis and St. Louis, Jefferson and St. Charles counties.

DHSS distributed 1,900 vials of the monkeypox vaccine to the county health department for use within the region and for distribution to other areas of the state that experience an increased need for vaccines, according to a press release from the health department.

Several people may be vaccinated with each vial, according to recent guidance from the Centers for Disease Control and Prevention (CDC).

Under the health departments current plan, a portion of the vials will be reserved for health departments and other health care providers to use to protect close contacts of people with monkeypox, according to the release.

The remaining vials will be available to health departments and clinics to vaccinate people who meet CDC criteria for being at high risk for the disease.

DHSS has set up a public survey to identify people who are at high risk for getting monkeypox and may qualify for the initial round of doses.

Monkeypox is a rare illness caused by infection with the monkeypox virus, which is related to the virus that causes smallpox, according to the health department.

Those with the disease usually have flu-like symptoms and fatigue, followed by a rash that looks like pimples, sores or blisters. The sores can be painful or itchy.

The monkeypox infection is rarely fatal.

Monkeypox is spread through close skin-to-skin contact or through shared clothing or bedding. Anyone can get the disease, but men who have sex with men have been most affected during the current outbreak, according to the health department. Those individuals will be prioritized in the departments current vaccine plan.

The vaccine protects against the disease, but it isnt used to treat people who have already contracted it. Vaccination consists of two doses per person and is administered four weeks apart, with maximum effectiveness at least two weeks after the second dose.

At this time, supply of the vaccine is limited across the country. Missouri health experts expect the demand for the vaccine to outweigh the supply. The county health department has requested additional doses of the vaccine and expects more from the state in the coming days, depending on availability.

For more information on monkeypox, visit the DHSS website.

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Plans to distribute the monkeypox vaccine in the St. Louis area - KSDK.com

Indiana will offer monkeypox vaccines to at-risk people. Here’s how to sign up – WFYI

August 13, 2022

The CDC recommends two doses of the JYNNEOS vaccine, spaced four to five weeks apart.

Updated 1 p.m. Aug. 12

The Indiana Department of Health is hosting monkeypox vaccination clinics for anyone who is at risk of exposure, including people who have been exposed to monkeypox and people who may be more likely to get it.

Indiana health officials said there will be 400 doses of the JYNNEOS monkeypox vaccine available at each of the following locations:

Allen County

Marion County

Tippecanoe County

The U.S. Centers for Disease Control and Prevention recommends vaccination for people at risk of contracting monkeypox, including:

The CDC recommends two doses of the JYNNEOS vaccine, spaced four to five weeks apart. It takes 14 days after the second dose for the vaccine to provide maximum immune protection, according to health officials.

IDOH recommends that people who get the vaccine continue to take precautions to protect themselves from infection. This includes using condoms or gloves and other safer sex practices and avoiding skin-to-skin contact with people who have monkeypox.

As of Aug. 10, the state of Indiana has received 6,752 doses of the JYNNEOS vaccine from the U.S. Department of Health and Human Services, according to the HHS website. Nearly 12,000 doses have been allocated to the state, out of about a million currently available. Federal health officials said theyre determining how to divvy up vaccines based on need and HHS is exploring ways to stretch the limited supply.

Anyone can register on the Health Departments monkeypox website to be notified of future vaccine clinics in their area.

Health officials encourage anyone who is a close contact of a positive monkeypox case to work with their health care provider on treatment options.

UPDATE: This story was updated to include additional information provided by the Indiana Department of Health.

This story comes from a reporting collaboration that includes the Indianapolis Recorder and Side Effects Public Media, a public health news initiative based at WFYI. Contact Farah at fyousry@wfyi.org. Follow on Twitter: @Farah_Yousrym.

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Indiana will offer monkeypox vaccines to at-risk people. Here's how to sign up - WFYI

Philly sex workers finally have access to the monkeypox vaccine – The Philadelphia Inquirer

August 13, 2022

Sex workers in Philadelphia are now eligible to receive the monkeypox vaccine, the Philadelphia Department of Public Health said Thursday, a relief for people at high risk of catching the virus.

Philadelphias limited supply of vaccine doses had been restricted to people with confirmed exposure to the virus, or men who have sex with men, are over 18 years old, and are considered high-risk for contracting the virus because they either have had multiple recent partners or were treated recently for a sexually transmitted infection. Transgender and nonbinary people are also eligible.

The decision to include anyone who does sex work came amid lobbying from activist groups and sex workers themselves.

It was so urgent for me, said a 42-year-old Philadelphia sex worker who calls herself Madeline Layne. I woke up in the middle of the night having a panic attack because I was so stressed about this. I cant really work until I get the vaccine.

Even with restrictions on who is eligible for the vaccine, the city has not been able to meet demand, and has been prioritizing doses for people who have a confirmed exposure to the virus.

Still, health officials decided it was important to add sex workers to the eligibility list because they are at high risk of contracting the virus, said health department spokesperson James Kyle.

If one of them catches monkeypox, its going to go all through the community, said Jazmyn Henderson, whose organization, ACT UP Philadelphia, an HIV and AIDS activist group, has sought to expand vaccine access. We need to be thinking about high risk populations differently.

READ MORE: Monkeypox vaccine limits cause frustration and fear in Philly

Others at risk, such as people experiencing homelessness who may share clothes, toiletries, and drug paraphernalia, and health care workers who treat people with monkeypox, are not yet eligible.

At this point, we havent seen cases among healthcare workers or unhoused individuals who dont also have other risk factors, Kyle said. However, these are important groups to watch, and we hope to be able to vaccinate these groups as soon as we have enough vaccine.

In the meantime, staff at Philadelphia FIGHT, an LGBTQ-focused health center, are wearing surgical gowns and gloves as extra protection, in addition to the masks and face shields they were already wearing because of COVID, said Jay Kostman, a doctor there.

On Tuesday, the U.S. Food and Drug Administration permitted health care providers to use smaller doses of the vaccine JYNNEOS to stretch the supply of doses as much as fivefold, federal health officials said. Philadelphias health department, though, has questions about the efficacy of the approach, and whether people can choose the amount of vaccine they receive, and has not yet started providing the smaller doses.

Monkeypox continues to spread widely in the United States, with the country cracking more than 10,000 cases as of Wednesday according to the Centers for Disease Control and Prevention. Philadelphia reported 128 cases Monday, the most recent data available.

READ MORE: Phillys monkeypox vaccine shortages arent solved yet as feds make move to increase access to the shots

Monkeypox spreads primarily through extended physical contact with the rashes and lesions it causes, and while it is not exclusively a sexually transmitted disease, the close contact of sex has proven to be an ideal means of transmission. The virus isnt fatal but can be extremely painful, with symptoms and the potential to infect others lasting for up to a month.

Monkeypox is really scary, especially to people for whom our appearance is such an important factor in our ability to make money, Layne said. If my face is covered in scars, Im done. Its really terrifying, honestly.

She asked that her legal name not be used to avoid stigma.

Layne has worked as an escort for about two years, she said, and developed a rigorous routine of testing and masking that allowed her to keep seeing clients through the COVID-19 pandemic. She wants to take the same approach to monkeypox, but there is no rapid test she can use, and a mask or condom cant reliably prevent contact with the rashes and lesions monkeypox causes, which may not be clearly apparent. Layne knows she has had male clients who are sexually active with men.

READ MORE: Exposed to monkeypox? Heres how to get a vaccination appointment in Philly.

This week and last week, Ive been more cautious because of monkeypox, said Layne, who has largely paused seeing clients. I can just kind of wait until I get the vaccine.

Layne had tweeted at the city health department, urging officials to make sex workers eligible for vaccination.

READ MORE: Are you at risk of getting monkeypox? Heres everything you need to know.

Philadelphia Red Umbrella Alliance, an advocacy group for city sex workers, has educated women working on the street about what monkeypox looks like and how it spreads, said Raani Begum, an organizer for the group. She is glad for greater access to the vaccine, but is concerned that women may not get it if they have to identify themselves as sex workers.

They have to expose themselves, and I think that can really keep them from accessing monkeypox vaccine, Begum said.

Sex workers have a complicated relationship with health care providers, Begum said, the result of stigma and discrimination they face. Women could fear how information provided to health care workers might be used or shared. Its something Layne has encountered too.

Theres always a stereotype of us being disease vectors, but our livelihoods depend on us being in good health, she said.

Though expanding eligibility to sex workers is a step in the right direction, health experts and activists say the city must do more. Kathleen Brady, a doctor and acting director of the health departments AIDS Activities Coordinating Office, said the agency relies on grant funds earmarked for specific programs, and cannot quickly redirect many employees to an unfunded crisis like monkeypox.

Last weeks federal public health emergency declaration is expected to send much-needed money to health departments for monkeypox response.

The response was definitely slow at the national level, Brady said. I think it should have been declared a public health emergency earlier without a doubt.

Health department staff will soon be reaching out to around 100 organizations, bars, venues, churches, and clubs that cater to LGBTQ people with information about the virus. Among them, she said, are two bath houses that cater to gay men, though they havent been receptive to other outreach efforts, Brady said. Neither returned a reporters calls.

Extended physical contact or even touching objects that touched the lesions on an infected person can spread the virus. The bath houses offer ample opportunity for transmission, Kostman said.

Yet, he said, its not necessarily sexual practices that put people in harms way.

Lets realize the potential risk is out there depending on behavior, he said, not just what group youre in.

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Philly sex workers finally have access to the monkeypox vaccine - The Philadelphia Inquirer

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