Monkeypox is an Expanding Global Concern Impacting Everyone

Since early May 2022, cases of monkeypox virus disease have been reported from countries where the disease is not endemic, and continue to be reported in several endemic countries, says the World Health Organization (WHO).

This is the first time that monkeypox cases and clusters have been reported concurrently in non-endemic in widely disparate geographical areas worldwide.

Most confirmed monkeypox cases do not have travel histories to Africa, where the virus is endemic.

As of July 22, 2022, over eighty-five countries have reported about 17,388 cases.

And in the USA, the U.S. CDC has now confirmed about 2,600 monkeypox patients during this ongoing outbreak.

Given the daily increase in new cases, many health experts are concerned this outbreak may become another pandemic, similar to COVID-19.

But, unlike the COVID-19 pandemic, U.S. FDA-approved monkeypox (MPX) vaccines and treatments are available today.

However, the European CDC reported in early July 2022 that mass vaccination for MPX is not required nor recommended. 

Unless contact tracing can successfully identify a high proportion of infected contacts, mathematical modeling results indicate that targeted preexposure prophylaxis (PrEP) of individuals at increased risk of exposure would be the most effective strategy to use vaccines to control the outbreak. 

Therefore, prioritizing groups of men at higher risk of exposure and front-line staff with a chance for occupational exposure should be considered in developing vaccination strategies. 

The modeling also suggests that post-exposure prophylaxis (PEP) vaccination of contacts would offer a marginally more efficient approach if there are both higher uptake levels and more effective tracing (as fewer vaccines would be needed for a relatively more significant increase in the probability of outbreak control per vaccinated individual).

In contrast, the absolute likelihood of outbreak control with PEP vaccination is still lower than with PrEP vaccination. 

In settings with higher vaccine uptake, PEP vaccination of close contacts of cases should also be considered, or even ring vaccination. 

Among these, contacts with a high risk of developing severe disease, like children, pregnant women, and immunocompromised individuals, should be prioritized.

As of July 22, 2022, there are two vaccines licensed by the U.S. Food and Drug Administration for preventing monkeypox infection – JYNNEOS® (Imvamune or Imvanex) and ACAM2000®.

The JYNNEOS vaccine is in very high demand throughout the USA.

Still, the federal government has limited inventory available to meet the needs in key cities, such as New York City, Washington, DC, and Chicago.

These cities and others are conducting vaccination events to enhance PrEP goals.

For example, there are about 17,000 first-dose vaccination appointments available in New York City this weekend, which are expected to fill up quickly, says NYC Health.

And if you have already received the first dose, you will be contacted about scheduling the second dose vaccination in the coming weeks.

If necessary, you can wait longer than four weeks between doses.

To reduce the chance of getting and spreading the monkeypox virus, if you have a new or unexpected rash or sore, do not have close physical contact with anyone until you have talked to a health care provider, says NYC Health.

Previously, the WHO issued Situation Report 1 on July 6, 2022. The WHO then issued a 'Moderate' Risk Assessment regarding the global monkeypox virus outbreak.

On July 23, 2022, the WHO is expected to report on the 2nd meeting of the IHR Emergency Committee regarding the multi-country outbreak of monkeypox. Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, and other senior officials are scheduled to offer their insights and suggested actions, such as vaccine access, testing, and travel restrictions.

Additional monkeypox outbreak news is posted on this weblink.  

Vax-Before-Travel publishes fact-checked, research-based vaccine news curated for international travelers.