As of early July, 2022, thousands of cases of monkeypox have been reported outside of Africa, primarily in Europe. Hundreds of cases have been reported in the US. A vaccine against monkeypox and smallpox, JYNNEOS, was approved in September 2019 by the FDA. As of June 23rd, the first monkeypox vaccine clinic in NYC opened within the Chelsea Sexual Health Clinic. Subsequently, more vaccine clinics have opened. For updated information regarding monkeypox vaccine availability and scheduling appointments, see NYC Health Clinics.
What Is Monkeypox?
Monkeypox is a rare infectious disease contracted through close contact with individuals or animals infected the monkeypox virus. First discovered over 60 years ago in non-human primates (monkeys) and rodents in Africa, almost all monkeypox cases were previously diagnosed in Africa or in travelers coming from Africa or importing animals from there. In 2022, however, cases have begun to appear in many individuals without a history of travel. In Europe, most cases have been in gay males, but cases are not limited only to this demographic and are likely significantly underreported overall.
The monkeypox virus belongs to the same family of viruses as smallpox (orthopoxviruses) It presents with some of the same signs and symptoms as smallpox, such as swollen lymph nodes, muscle aches, and pimple-like blisters and rashes. Monkeypox usually causes a milder illness than smallpox, with a much lower fatality rate (generally, less than 1% vs up to 30% for smallpox). Monkeypox is not related to chickenpox.
Signs and symptoms of monkeypox:
- Pimples, blisters, and other rashes
- Swollen lymph nodes
- Muscle aches
In some cases, the symptoms start with rashes on various parts of the body, such as the face, the mouth, chest, feet, hands, genitals, and around the anus. Often the rash is associated with swollen lymph nodes. The lesions can appear as deep blisters, pimples, or lesions with depressed centers. Some people only get a rash without the other symptoms listed above.
Examples of monkeypox skin lesions:
Images from CDC.gov
How is monkeypox contracted?
- Direct contact with monkeypox rashes/lesions.
- Mucus-membrane contact with someone who has monkeypox (sexual contact (oral or genital), kissing, etc.).
- Prolonged unmasked exposure to someone with monkeypox (transmission through the air is much less likely with monkeypox (large droplets) than with COVID-19 (small droplets/aerosol)).
Tips to prevent monkeypox:
- Avoid sexual contact with people who are ill with symptoms and signs of monkeypox.
- Avoid close contact with monkeypox skin lesions (or bedding, towels, etc., that have been exposed to them) until all lesions have scabbed and fallen off.
- Masking and avoidance of prolonged time in close proximity indoors to someone suspected to have monkeypox will decrease the chance of respiratory droplet spread.
- Consider the JYNNEOS vaccine if you believe you may either have been exposed to someone with monkeypox or your risk of future exposure is very high.
What is JYNNEOS (Monkeypox Vaccine)?
JYNNEOS (Imvanex in Europe and the UK and Imvamune in Canada) is an FDA-approved live virus vaccine for the prevention of monkeypox. The Advisory Committee on Immunization Practices (ACIP) recommends JYNNEOS as pre-exposure prophylaxis for individuals at high risk of exposure to orthopoxviruses, such as monkeypox and smallpox, and post-exposure prevention of these diseases. The vaccine is administered as a two-dose series one month apart. CURRENTLY, THE VACCINE HAS VERY LIMITED AVAILABILITY IN NYC.
What are the side effects of the monkeypox vaccine?
- Muscle pain
- Pain, redness, and/or swelling at the vaccination site
Is the monkeypox vaccine dangerous?
The JYNNEOS monkeypox vaccine is FDA-approved as pre-exposure prophylaxis for individuals over 18 years of age. You may experience side effects, but they are generally mild.
Is there treatment for Monkeypox?
Antivirals such as cidofovir, tecovirimat, and vaccina immunoglobulin are potentially available through state health departments.
Where can I find out more information about the monkeypox vaccine?
For the official Vaccine Information Statement, please go to Smallpox/Monkeypox VIS.
Monkeypox Vaccine in NYC
Travel Medicine Consultations is a medical clinic dedicated to helping individuals travel across the world better prepared with information, vaccinations, and medication. Unfortunately, monkeypox seems to be one of the newest infectious risks we all may face in the US and abroad. Please schedule a consultation with Dr. Julian Klapowitz before your trip for more information about monkeypox and the monkeypox vaccine. Please visit The NYS Department of Health/Monkeypox and CDC Monkeypox Information for more regarding monkeypox.