According to VA Northern California
Does VANCHCS offer monkeypox vaccines to patients or employees?
According to the CDC, the U.S. currently has a limited supply of JYNNEOS, although more is expected in the coming weeks and months. VANCHCS has a small supply of Jynneos, an FDA-approved smallpox vaccine that provides protection against monkeypox. This vaccine is intended for those at the highest risk for monkeypox or those who have had known exposure.
- In California, people aged 25 to 44 make up nearly three-quarters (~74.5%) of cases in the state.
- Whites and Hispanic/Latinx people are showing the most cases, making up ~80.6% of CA cases.
- Monkeypox is showing more prevalence among males at 98.3% followed by trans men (0.6%), women (0.4%), trans women (0.4%) & genderqueer/non-binary (0.3%).
- Gay, lesbian, and same gender-loving individuals make up 91.7% of monkeypox cases in California, followed by bisexual people at 5.6% and heterosexuals at 2% respectively.
What is Monkeypox?
Monkeypox is a rare disease caused by infection with the monkeypox virus. Monkeypox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. Monkeypox symptoms are similar to smallpox symptoms, but milder, and monkeypox is rarely fatal. Monkeypox is not related to chickenpox.
Monkeypox was discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Despite being named “monkeypox,” the source of the disease remains unknown. However, African rodents and non-human primates (like monkeys) might harbor the virus and infect people.
The first human case of monkeypox was recorded in 1970. Prior to the 2022 outbreak, monkeypox had been reported in people in several central and western African countries. Previously, almost all monkeypox cases in people outside of Africa were linked to international travel to countries where the disease commonly occurs or through imported animals. These cases occurred on multiple continents.
Signs & Symptoms
Signs include a rash that may be located on or near the genitals or anus but could also be on other areas like the hands, feet, chest, face, and mouth. The rash may go through several stages, including scabs, before healing. It can look like pimples or blisters and may be painful or itchy.
Symptoms can include the following:
- Muscle ache and backache
- Swollen lymph nodes
- Respiratory symptoms like sore throat, nasal congestion, or cough.
You may experience some or all the symptoms. Sometimes, a rash appears first followed by other symptoms; others may experience only a rash. Most people will get a rash however.
Symptoms usually start within three (3) weeks after exposure. Someone with flu-like symptoms will usually develop a rash from one to four days later.
Monkeypox can be spread from the time symptoms start up until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed.
Monkeypox typically lasts from two to four weeks.
If you have new or unexplained rash or other symptoms:
- Avoid close contact, including sex or being intimate with anyone, until you have been checked out by a healthcare provider.
- If you don’t have a provider or insurance, visit a public health clinic near you.
- When you see a healthcare provider, wear a mask, and remind them that this virus is circulating in the area.
Prevention for Yourself
- Avoid close, skin-to-skin contact with people who have a rash that looks like monkey pox.
- Do not touch the rash or scabs of a person with monkeypox.
- Do not kiss, hug, cuddle, or have sex with someone with monkeypox.
- Avoid contact with objects or materials that a person with monkeypox has used.
- Do not share eating utensils or cups with someone with monkeypox.
- Do not share or touch the bedding, towels, or clothing of a person with monkeypox.
- Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before touching your face and after you use the bathroom.
Prevention During Sex
Talk to your partner about any recent illness and be aware of new or unexplained rashes on your body or your partner’s body, including the genitals and anus. If you or your partner have recently been sick, currently feel sick, or have a new or an unexplained rash, do not have sex and see a healthcare provider.
If you or a partner has monkeypox, the best way to protect yourself and others is to avoid sex of any kind (oral, anal, vaginal) and do not kiss or touch each other’s bodies while you are sick, especially any rash. Do not share things like towels, fetish gear, sex toys, and toothbrushes.
If you or your partner have (or think you might have) monkeypox and you decide to have sex, consider the following to reduce the chance of spreading the virus:
- Have virtual sex with no in-person contact.
- Masturbate together at a distance of at least 6 feet, without touching each other and without touching any rash.
- Consider having sex with your clothes on or covering areas where rash is present, reducing as much skin-to-skin contact as possible. If the rash is confined to the genitals or anus, condoms may help; however, condoms alone are likely not enough to prevent monkeypox.
- Avoid kissing.
- Remember to wash your hands, fetish gear, sex toys and any fabrics (bedding, towels, clothing) after having sex. Learn more about infection control.
- Having multiple or anonymous sex partners may increase your chances of exposure to monkeypox. Limiting your number of sex partners may reduce the possibility of exposure.
- Avoid touching the rash. Touching the rash can spread it to other parts of the body and may delay healing.
Prevention at Social Gatherings like Raves, Parties, Clubs & Festivals
When thinking about what to do, seek out information from trusted sources like the local health department. Second, consider how much close, personal, skin-to-skin contact is likely to occur at the event you plan to attend. If you feel sick or have a rash, do not attend any gathering, and see a healthcare provider.
- Festivals, events, and concerts where attendees are fully clothed and unlikely to share skin-to-skin contact are safer. However, attendees should be mindful of activities (like kissing) that might spread monkeypox.
- A rave, party, or club where there is minimal clothing and where there is direct, personal, often skin-to-skin contact has some risk. Avoid any rash you see on others and consider minimizing skin-to-skin contact.
- Enclosed spaces, such as back rooms, saunas, sex clubs, or private and public sex parties where intimate, often anonymous sexual contact with multiple partners occurs, may have a higher likelihood of spreading monkeypox.
What To Do If You Have a New/Unexplained Rash or Other Symptoms
- Avoid sex or being intimate with anyone until you have been checked out by a healthcare provider.
- If you don’t have a provider or health insurance, visit a public health clinic.
- When you see a provider, wear a mask.
- Avoid gatherings, especially if they involve close, personal, skin-to-skin contact.
Think about the people you have had close, personal, or sexual contact during the last 21 days, including people you met through dating apps. To help stop the spread, you might be asked to share this information if you have received a monkeypox diagnosis.
There are no treatments specifically for monkeypox virus infections. However, monkeypox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat monkeypox virus infections.
Antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems.
If you have symptoms of monkeypox, you should talk to your healthcare provider, even if you don’t think you had contact with someone who has monkeypox.
Vaccination helps to protect against monkeypox when given before or shortly after an exposure. JYNNEOS and ACAM2000 are two monkeypox vaccines currently available in the United States via the Strategic National Stockpile.
At this time, the federal government has allocated a limited number of JYNNEOS vaccine doses to Californians. CDPH is working with local health departments to make these doses available to protect against monkeypox. JYNNEOS is licensed for adults 18 years and over. It is administered as a two dose injection series in the upper arm at least four weeks apart. Most people who receive the JYNNEOS vaccine have only minor reactions such as pain, redness, swelling and itching at the injection site. Less commonly, people also may experience muscle pain, headache, fatigue (tiredness), nausea, chills, and fever.
The CDC advises that people who have been exposed to monkeypox be given the vaccine to prevent them from developing the disease. This is called post-exposure prophylaxis or PEP. PEP is most effective at preventing monkeypox if the vaccine is administered within 4 days of exposure. If given between 4–14 days after the date of exposure, vaccination may help reduce symptoms, but may not prevent the infection from developing.
At this time, the JYNNEOS vaccine is being prioritized for the following groups:
- Post-Exposure Prophylaxis (PEP) for known close contacts of monkeypox cases who are identified by public health via case investigation, contact tracing, and risk exposure assessments.
- Post-Exposure Prophylaxis (PEP)++ for individuals with certain risk factors who are more likely to have been recently exposed to monkeypox even if they have not had documented exposure to someone with confirmed monkeypox, such as people who attended an event or venue where there was known monkeypox exposure.
- Pre-Exposure Prophylaxis (PrEP) for individuals at occupational risk of monkeypox according to Advisory Committee on Immunization Practices (ACIP) guidance, including: laboratory workers who perform monkeypox testing, and clinical and public health workers who collect monkeypox specimens.
On July 19, California sent a letter to the Centers for Disease Control and Prevention outlining a request for additional doses of vaccine. Additional doses will eventually allow for expansion of vaccination efforts to include PrEP to other individuals, including gay, bisexual, trans and other men who have sex with men who are at high risk of monkeypox exposure.