Smallpox vaccine for monkeypox to be extended to people at high risk

Plans to extend the use of the smallpox vaccine for individuals at high risk of monkeypox infection in the State were announced by the Minister for Health on Tuesday.

The vaccine will be offered to gay and bisexual men, other men who have sex with men, as well as others at high risk of exposure.

It follows recommendations made last week by the National Immunisation Advisory Committee (Niac) to the interim chief medical officer (CMO).

Niac recommended that two doses of the smallpox vaccine be administered 28 days apart to “as many high-risk individuals as soon as possible”.

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Minister for Health Stephen Donnelly welcomed the recommendations, which “represent an important step in our ongoing response to the monkeypox outbreak”.

“Monkeypox is usually a self-limiting illness, and most people recover within a few weeks. However, the rapid spread of infection necessitates further measures beyond those currently in place. The evidence suggests this approach to targeted pre-exposure prophylaxis may be highly efficient in controlling further spread of the disease,” he said.

The Department of Health and the Health Service Executive will now work to implement these new recommendations.

Interim CMO Breda Smyth said the recommendations “reflect a strengthening of measures to control disease transmission and ensures that our response to this evolving situation is informed by the best available evidence”.

Prof Smyth “strongly encouraged” those with symptoms of infection to seek medical advice and follow the public health guidance.

On Saturday, the World Health Organisation declared the monkeypox outbreak a public health emergency of international concern.

Stephen O’Hare, executive director of HIV Ireland, said the move was “very much welcomed” and HIV Ireland is now calling for “a concrete action plan” on how the rollout of the vaccine will work.

HIV Ireland board member and consultant in infectious diseases at St Vincent’s University Hospital Paddy Mallon said key priorities in Ireland “must include increasing awareness within the community in general about the signs and symptoms of monkeypox, accurate information on how it can be transmitted and expanding access to testing and increasing availability of vaccination”.

The most likely route of monkeypox transmission is close physical contact, touching clothing, bedding or towels used by someone with the monkeypox rash, or touching monkeypox skin blisters or scabs.

Sexual intercourse is thought to expose people to a higher risk of contracting the disease as, although it is not known to be sexually transmitted, the close physical contact involved means exposure is more likely.

Most of the cases seen so far have been in gay and bisexual men and men who have sex with men.

Most monkeypox patients experience only fever, body aches, chills and fatigue, but some may develop a rash and lesions on the face and hands that can spread to other parts of the body.

Most people recover within a few weeks. The incubation period of monkeypox is usually six to 13 days, but can range from five to 21 days.