health

Gay and bisexual men WILL be offered monkeypox vaccine in targeted rollout


Gay and bisexual men who are at a ‘high risk’ of catching monkeypox are set to be offered a vaccine to protect against the infection, health chiefs announced today. 

Nearly 800 cases of the virus, which is usually only spotted in Africa, have been reported in the UK. Almost all infections so far have been spotted in men who have sex with men.

In a bid to stem case numbers, the UK Health Security Agency (UKHSA) today confirmed some gay and bisexual men would be offered the Imvanex vaccine — which is 85 per cent effective — to control the outbreak.

Under the plans, which come from the same experts who advised on the Covid vaccine rollout, medics will offer the jab to men who have multiple partners, participates in group sex or attends ‘sex on premises’ venues.

Until now, the jab was only offered to confirmed cases and their close contacts under a strategy called ring vaccination, which has been proven to work in other outbreaks.

Experts told MailOnline a fortnight ago the next sensible step if infections continued to spiral would be to widen the vaccination programme in a targeted rollout to more men who have sex with men, anyone visiting a sexual health clinic and NHS staff.

It comes as Covid-weary Britons were today warned that the monkeypox outbreak could get 10 times bigger by experts behind gloomy models used to justify lockdown restrictions. The modelling suggested, however, that any surge in cases among groups other than gay and bisexual men was ‘unlikely’.

Meanwhile, British health bosses reported another 219 infections today — the highest daily toll — bringing the UK total to 793. London is the country’s virus hotspot.

Dozens of countries, including the US, Spain and Germany, have been struck by the outbreak — the biggest ever detected outside of Africa to date. Almost all of infections so far have been spotted in the men who have sex with other men community.

In a bid to stem case numbers, the UK Health Security Agency (UKHSA) today confirmed some gay and bisexual men would be offered the Imvanex vaccine — which is 85 per cent effective — to control the outbreak. Under the plans, which come from the same experts who advised on the Covid vaccine rollout, medics will offer the jab to men who have multiple partners, participates in group sex or attends 'sex on premises' venues. Until now, the jab was only offered to confirmed cases and their close contacts under a strategy called ring vaccination, which has been proven to work in other outbreaks

In a bid to stem case numbers, the UK Health Security Agency (UKHSA) today confirmed some gay and bisexual men would be offered the Imvanex vaccine — which is 85 per cent effective — to control the outbreak. Under the plans, which come from the same experts who advised on the Covid vaccine rollout, medics will offer the jab to men who have multiple partners, participates in group sex or attends ‘sex on premises’ venues. Until now, the jab was only offered to confirmed cases and their close contacts under a strategy called ring vaccination, which has been proven to work in other outbreaks 

Timeline of monkeypox 

1958: Monkeypox was first discovered when an outbreak of a pox-like disease occurred in monkeys kept for research.

1970: The first human case was recorded in 1970 in the Democratic Republic of Congo and the infection has been reported in a number of central and western African countries since then.

2003: A Monkeypox outbreak occurred in the US after rodents were imported from Africa. Cases were reported in both humans and pet prairie dogs. All the human infections followed contact with an infected pet and all patients recovered.

SEPTEMBER 8, 2018: Monkeypox appeared in the UK for the first time in a Nigerian naval officer who was visiting Cornwall for training. They were treated at the Royal Free Hospital in London.

SEPTEMBER 11, 2018: A second UK monkeypox case is confirmed in Blackpool. There is no link with the first case in Cornwall. Instead, the patient is though to have picked up the infection when travelling in Nigeria. They were treated at Blackpool Victoria Hospital and Royal Liverpool University Hospital.

SEPTEMBER 26, 2018: A third person is diagnosed with monkeypox. The individual worked at Blackpool Victoria Hospital and treated the second Monkeypox case. They received treatment at the Royal Victoria Infirmary in Newcastle.

DECEMBER 3, 2019: A patient was diagnosed with monkeypox in England, marking the fourth ever case.

MAY 25, 2021: Two cases of monkeypox were identified in north Wales. Both patients had travel links to Nigeria.

A third person living with one of the cases was diagnosed and admitted to hospital, bringing the total number ever to seven.

MAY 7, 2022: A person was diagnosed with Monkeypox in England after recently travelling to Nigeria. The person received care at the expert infectious disease unit at Guy’s and St Thomas’ NHS Foundation Trust in London. Experts have suggested the virus was spreading in the UK for months before this case was spotted.

MAY 14, 2022: Two more cases were confirmed in London. The infected pair lived in the same household but had not been in contact with the case announced one week earlier.

One of these individuals received care at the expert infectious disease unit at St Mary’s Hospital in London. The other isolated at home and did not need hospital treatment.

MAY 16, 2022: Four more cases were announced, bringing the UK total to seven. Three of these cases are in London, while one of their contacts is infected in the north east of England.

The UKHSA first confirms that the spate of cases, described as ‘unusual’ and ‘surprising’, are mainly among gay and bisexual men and advises them to look out for new rashes.

MAY 19, 2022: Two more cases were revealed, with no travel links or connections to other cases. The cases were based in the South East and London. Fears began to grow that infections are going undetected.

MAY 20, 2022: Eleven more cases are announced, meaning Britain’s monkeypox outbreak have doubled to 20. Minsters discuss the possibility of a public health campaign to warn gay men the disease may be more prevalent for them

MAY 23-26, 2022: Scotland, Wales and Northern Ireland log their first ever monkeypox cases.

MAY 29, 2022: World Health Organization (WHO) says risk of monkeypox is ‘moderate’, citing concerns about virus infecting children and immunosuppressed people if it becomes more widespread.

JUNE 7, 2022: The UKHSA declares monkeypox a notifiable disease. It means all medics must alert local health authorities to suspected cases. The tropical virus now carries the same legal status as the plague, rabies and measles.

 

The UKHSA today published a strategy which set out that some gay and bisexual men at ‘higher risk’ of exposure to monkeypox should be offered a vaccine to control the outbreak.

Officials have not put a number on how many men will be included in the rollout.

Anyone can catch the virus, which is spread by close contact with an infected person. But most cases in the ongoing surge are among the ‘sexual networks’ of men who have sex with men. 

Monkeypox, which will be renamed because of claims that it is discriminatory towards Africa, is not normally a sexually-transmitted infection.

But it is thought to be the main mode of transmission in the ongoing outbreak. 

The virus, first discovered in lab monkeys in the 1950s, can also be spread through touching clothing, bedding or towels used by someone who is infected.

Under the plans, endorsed by the Joint Committee on Vaccination and Immunisation (JCVI), those eligible for  pre-exposure prophylaxis (PrEP) — a pill that protects against HIV — will also be eligible for the vaccine.

This includes people who do not always use condoms during sex and are likely to continue not using them, as well as sex workers or their clients who report having unprotected sex.

NHS England is due to set out details on how eligible people can get vaccinated. People are advised not to come forward for the vaccine until contacted.

As well as gay and bisexual men, the list of NHS staff eligible for the jab is also being expanded.

Healthcare workers caring for monkeypox patients in specialist high consequence infectious disease (HICD) wards are already offered the jab. But now staff in other hospitals designed to care for monkeypox patients will also be offered the jab, as well as workers in laboratories that test for the virus.

Dr Mary Ramsay, head of immunisation at UKHSA, said: ‘Our extensive contact tracing work has helped to limit the spread of the monkeypox virus, but we are continuing to see a notable proportion of cases in gay, bisexual and other men who have sex with men. 

‘By expanding the vaccine offer to those at higher risk, we hope to break chains of transmission and help contain the outbreak.

‘Although most cases are mild, severe illness can occur in some people, so it is important we use the available vaccine to target groups where spread is ongoing. The NHS will soon set out details on how this will be delivered – so do not come forward for the vaccine yet.’

The UKHSA is urging all Britons to be alert to any new spots, ulcers or blisters on any part of their body, particularly if they have had close contact with a new partner. Those with symptoms are told to avoid close contact with others and call NHS 111 or your local sexual health centre.

Alex Sparrowhawk, health promotion specialist at HIV charity Terrence Higgins Trust, said: ‘This targeted vaccination programme is a positive move forward while the data still shows monkeypox is disproportionately affecting gay and bisexual men in the UK.’

Robbie de Santos, director of communications and external affairs at LGBT charity Stonewall said it welcomed the vaccine being offered to those who are most at risk of catching the virus.

He said: ‘It is important that gay and bi men get the vaccine when offered to protect themselves and others. Let’s help get the outbreak under control so we can all have a safe and happy pride season.’

It comes as the UKHSA today confirmed Britain’s outbreak has grown by 38 per cent since Friday to 793.

Among the 766 cases with confirmed addresses, 498 are in London, 37 are in the South East and 26 are in the North West. All other regions have logged 20 cases or fewer.

Public Health Scotland on Sunday said that all cases appear to be ‘generally mild and not life-threatening’ with no reported deaths in the UK to date.

Monkeypox cases have been aged 37, on average, health bosses said.  

Meanwhile, scientists behind the monkeypox modelling that warned of another 10,000 cases include Professor John Edmunds, an LSHTM epidemiologist who was among the most outspoken SAGE members during the Covid outbreak.

Two other study authors are also Government advisers, sitting on the notorious SPI-M modelling committee. It warned of up to 6,000 deaths per day in the run-up to the Christmas just gone, despite the actual peak being 20 times lower.

Without tough interventions, they also warned Omicron could potentially cause daily hospitalisations to breach 10,000 — quadruple the figure that happened in reality.

In their latest modelling, Professor Edmunds and other LSHTM scientists looked at how monkeypox could keep spreading.

Their estimates were based on sexual partnership data in the UK, gathered from a survey of 45,000 people that is conducted every decade.

At the time of the modelling on May 31, 728 confirmed and suspected cases had been reported worldwide in more than 25 countries. Since then, almost 3,000 infections have been logged worldwide.

Officials are urging gay and bisexual men to be aware of new lesions, rashes or scabs and get in contact with a sexual health clinic

Officials are urging gay and bisexual men to be aware of new lesions, rashes or scabs and get in contact with a sexual health clinic

The infection often starts with small bumps that scab over and are contagious

The infection often starts with small bumps that scab over and are contagious

The results, published on pre-print website medRxiv, show that without interventions or changes in sexual behaviour, it is ‘highly likely’ that a ‘major outbreak’ would be seen among men who have sex with men.

A major outbreak was defined as being at least another 10,000 cases, on top of the ones already detected.

The modellers said their findings, which have not been peer-reviewed, show that a ‘small fraction’ of individuals with a ‘disproportionately large’ number of sexual partners could explain the ‘sustained growth’ of monkeypox among men who have sex with men.

Monkeypox likely always had the risk of ‘substantial transmission potential’ among this community, their paper states. 

But it has not been able to take off because too few cases have been logged outside of Africa over the past few decades, they said.

However, the team said sustained transmission in other groups is ‘unlikely’. 

But they noted that between 10 and 10,000 extra cases could be spotted outside of the men who have sex with men community if lots of this group become infected.

The monkeypox R rate — a term made famous during the pandemic, which reflects the number of people an infected person passes the virus onto — may be ‘substantially greater than one’ which could make it challenging to contain the outbreak, their paper states. 

Contact tracing and vaccinating close contacts of infected people — the approaches used in the UK — only work if almost all contacts of an infected person are identified, they warned.

They said experts should identify ‘acceptable and effective’ ways of preventing transmission among men with the highest number of sexual partners who could have a ‘disproportionate effect on transmission overall’.

Monkeypox is usually mild and has an incubation period of up to 21 days, meaning it can take three weeks for the tell-tale symptoms to appear.

Symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion. A rash can develop, often beginning on the face, which then spreads to other parts of the body including the genitals.

It can, however, kill up to 10 per cent of people it infects. But the milder strain causing the current outbreak has a case-fatality rate of around one in 100 — similar to when Covid first hit. 

No deaths linked with the ongoing outbreak have yet been reported.

Outside of the UK, Spain (497), Germany (421) and Portugal (297) have logged the most infections.

Experts have warned monkeypox could become endemic among animals in Europe, as it is in parts of Nigeria, if the virus spreads to pets and wildlife. This would make animals a permanent reservoir of the virus that could infect humans, triggering sporadic outbreaks.



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