The document said pre-exposure vaccination should be prioritised as there is “very limited evidence” on whether the vaccine given after exposure can make any difference, but it also recommended rapid post-exposure vaccination for “those who are at higher risk of the complications of monkeypox” including pregnant women, the immunosuppressed, and children under the age of 10 to 11.
Test tube labelled “Monkeypox virus positive” in a photo illustration taken on May 22, 2022. The other prioritised groups are health and laboratory workers who are more likely to be exposed to monkeypox virus or other pox viruses. The JCVI said those at higher risk among the GBMSM can be identified using markers of high-risk behaviour such as “a recent history of multiple partners, participating in group sex, attending sex on premises venues,” or a proxy marker such as recent sexually transmitted bacterial infection in the past year. The vaccine that is being offered in the UK, smallpox Modified Vaccinia Ankara–Bavarian Nordic (MVA-BN), was licensed for smallpox in the UK and Europe but was also licensed for monkeypox in the United States under a different brand name. There are currently no monkeypox vaccines licensed in the UK or Europe, but vaccines developed for smallpox are considered to provide cross-protection against monkeypox as the two viruses are related. The Joint Committee on Vaccination and Immunisation (JCVI) has recommended that GBMSM be offered smallpox vaccines “as soon as feasible,” given they are “at highest risk due to a large number of contacts,” the UKHSA said.
In a vaccination strategy published on Tuesday, the agency said although anyone can contract monkeypox, the current outbreak is “primarily in gay, bisexual, and other men who have sex with men (GBMSM)” who have “largely been located in the London area.” Gay men, especially those with multiple partners or who have participated in group sex, will be the main target in the UK’s monkeypox vaccination campaign, the Health Security Agency (UKHSA) said.