Written Statement: UKHSA advice on Monkeypox Vaccination Strategy

Yesterday the UK Health Security Agency issued an updated strategy setting out  recommendations on vaccination in relation to the monkeypox outbreak. The strategy has been endorsed by the Joint Committee on Vaccination and Immunisation (JCVI), which was consulted on the eligibility criteria for the vaccine. The main aim of this vaccination strategy is to interrupt transmission and to bring the monkeypox outbreak under control.

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.

The strategy recommends the use of the Imvanex vaccine as part of a reactive vaccination strategy targeting a those people who are at an increased risk of exposure. They have recommended a pre-exposure vaccination programme for the following groups:

• Gay, bisexual or men who have sex with men with a large number of contacts
• Some healthcare workers at risk of exposure, including some working in sexual health services and high consequence infectious disease (HCID) units.

There will also be a limited post-exposure vaccination element to the programme of household and sexual contacts of confirmed cases, ideally within four days of exposure, extended to up to 14 days for those who are at an ongoing risk or are at a higher risk of the complications of monkeypox.

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 Wales will begin rolling out this strategy in line with these recommendations as soon as possible. People are advised not to come forward for the vaccine until contacted.

There has been 8 confirmed cases of monkeypox in Wales to 22 June but further community transmission appears highly likely and more cases are anticipated.

The risk to gay, bisexual and men who have sex with men and the general population is small overall, which is why mass vaccination is not recommended at this point. Monkeypox does not spread easily between people and transmission usually occurs through close contact. The illness is usually self-limiting and most people recover within several weeks.

Everyone is being asked to be aware of monkeypox symptoms but it’s particularly important gay, bisexual, and other men who have sex with men are alert. People should be aware of any unusual rashes or lesions on any part of their body, especially their genitalia. They should contact NHS 111 or a sexual health service if they have concerns.

We have also amended the Health Protection (Notification) (Wales) Regulations 2010 to make monkeypox a notifiable disease. This will oblige medical practitioners to notify the relevant local authority of any suspected or confirmed cases of monkeypox. In addition, diagnostic laboratories will be obliged to report if they identify monkeypox virus as a causative agent.

I am extremely grateful to the NHS and everyone involved in supporting the monkeypox response and all vaccination programmes for their continued hard work.