Monkeypox Vaccine Supply to Expand by Thousands

The federal government is rolling out thousands of additional doses of a vaccine to combat monkeypox, which has broken out across the U.S. with a concentration among men who have sex with men.

The Department of Health and Human Services announced Tuesday that it's distributing 296,000 doses of the JYNNEOS vaccine, of which 56,000 doses will be made available immediately, with the remaining 240,000 doses to be made available in the next few weeks.

HHS expects more than 750,000 additional JYNNEOS doses to be made available over the summer, and an additional 500,000 doses will undergo completion, inspection, and release throughout the fall, totaling 1.6 million doses available this year. The federal government is also expanding testing for the virus.

The vaccine will also be offered not just to people who've been exposed to someone with a confirmed case of monkeypox, as it has been, but to those who believe they've been exposed. "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," says an HHS press release.

The outbreak, about 350 cases across about 25 states, has many people worried, but there is some reassuring news. Monkeypox virus, or MPV, isn't a new, unknown virus like COVID-19, it's seldom fatal (there have been no deaths due to the latest U.S. outbreak), and cases are usually self-limiting, although people with compromised immune systems due to HIV or other factors may develop more serious symptoms. The vaccine has been around for a while, and so has treatment.

"The U.S. has had monkeypox outbreaks in the past 20 years, and we've been able to respond effectively," Dr. Raj Panjabi, senior director for global health security at the White House, told The Advocate Tuesday.

But MPV, the name Panjabi prefers to use for the virus, can be unpleasant and painful, so that's good reason to get vaccinated against it. The primary symptoms are fever, headache, exhaustion, muscle aches and backache, swollen lymph nodes, chills, and a rash that can look like pimples or blisters, appearing on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.

It is spread primarily through skin-to-skin contact, so it can be transmitted between sexual partners, although not through bodily fluids, such as semen or vaginal secretions.

About 95 percent of the documented cases in the U.S. have been among gay and bisexual men, Panjabi said, and mostly in large cities, including New York, Chicago, Los Angeles, and San Francisco. But he emphasizes that MPV is not a disease of identity; the most recent outbreak just happened to take root in this population. "Infectious disease knows no boundaries," he said, and there should be no stigma attached to the virus.

In a follow-up conference call with reporters from LGBTQ+ publications Wednesday, Dr. Anthony Fauci emphasized, "It is not a disease that will be essentially restricted to men who have sex with men." Making that assumption about HIV in the early years of that epidemic was a major mistake, added Fauci, director of the National Institute of Allergy and Infectious Diseases and the chief medical advisor to the president.

To get the word out about MPV, White House officials and others from the federal government have been meeting almost daily with LGBTQ+ community and health leaders across the nation, Panjabi noted.

The JYNNEOS vaccine is administered in two doses four weeks apart. Two weeks after the second dose, there is maximum immunity, so recipients either won't contract the virus or will have a milder case than if they didn't receive the vaccine.

There is another vaccine against MPV, ACAM2000, which is actually a smallpox vaccine. States and territories can request it to supplement the supply of JYNNEOS, but ACAM2000 has a risk of serious side effects. It therefore can't be administered to people who have compromised immune systems, including those with HIV or cancer, or people with heart disease.

The JYNNEOS vaccine will be allocated using a four-tier distribution strategy that prioritizes areas with the highest case rates of MPV. Within each tier, doses of JYNNEOS will be allocated based on the number of people at risk for MPV who also have a contraindication to ACAM2000. To find out if you should be tested for MPV or can get the vaccine, Panjabi suggests contacting a clinic that focuses on LGBTQ+ people, if your area has one, or your primary care physician.

Asked why vaccination is not being recommended for everyone, Fauci said that would not be practical because there is a limited supply of the safer vaccine, JYNNEOS.

If a person does contract MPV, it usually goes away within two to four weeks and can be managed with pain medications. Those who are immunocompromised are at risk for more serious cases of MPV. People who have a severe case or are likely to develop one, due to a weakened immune system, may be treated with TPOXX (generic name tecovirimat). The drug was developed to treat smallpox, but that disease and MPV are similar.

For testing, last week the Centers for Disease Control and Prevention began shipping tests to test to five major commercial laboratory companies to increase testing capacity. There are already 78 testing sites in 48 states, Panjabi noted.

Both Panjabi and Fauci stressed that the MPV outbreak should not panic people or lead them to end all interaction with others, but everyone should just be aware that the virus is out there and be on the watch for symptoms.

GLAAD President and CEO: Sarah Kate Ellis issued a statement praising the government's response. "HHS' vaccination strategy is critically necessary to protect vulnerable people and the public at large. Media must do their part to elevate information that all communities need to hear to be safe: anyone can get the virus if they come into contact with it. Media must continue to hold public health officials accountable to accurate data gathering, testing, treatment and vaccine distribution to stop the spread of this virus."

To learn more about MPV, visit the CDC's informational page. The White House also has a fact sheet on its response.