UK health officials are planning to more widely offer smallpox vaccines—which are effective against the related monkeypox virus—to some gay and bisexual men. The expanded outreach is part of a renewed strategy to contain the emerging viral disease, which recently has spread far beyond the few areas of the world where it was previously endemic. Outbreaks this year have been concentrated among men who sleep with men, but the virus can spread to anyone through close contact and possibly respiratory particles.
On Tuesday, the UK Health Security Agency unveiled its new plan, which was endorsed by the country’s Joint Committee on Vaccination and Immunization. Doctors and clinics will soon be told to offer the smallpox vaccine Imvanex to patients considered to be at higher risk for exposure to monkeypox. The criteria for higher risk will be similar to those used to assess eligibility for HIV pre-exposure prophylaxis (PrEP). It will include men who sleep with men who also have multiple sexual partners, as well as those who regularly participate in group sex or attend “sex on premises” venues.
There have been at least 2,500 confirmed and suspected cases of monkeypox reported globally this year, in over two dozen countries. The UK was the first country to document the unprecedented rise in cases and has now reported over 400 cases; the U.S. has reported over 140, with the most in California and New York currently. Cases have significantly increased in recent weeks, though only one death has been reported so far.
Up until recently, the virus that causes monkeypox had only occasionally spread to humans from animals in some parts of Africa, with rodents thought to be the usual hosts. Scientists are still trying to figure out whether the virus has changed to become more transmissible. But it appears that the virus’s far greater spread in 2022 has largely been driven by close contact between humans during sex, with transmission further amplified through sexual networks of gay and bisexual men.
Experts have been careful to note that monkeypox isn’t a “gay” disease, and the virus can infect and sicken anyone unlucky enough to be exposed to it. But they’ve also emphasized that the best hope of containing the virus, hopefully before it establishes itself in new host reservoirs around the world, is to curb transmission among higher risk individuals. The vaccines available against smallpox are thought to be effective (perhaps 85%, based on limited data) against related viruses, monkeypox included, and they can even be used as post-exposure prophylaxis, meaning they can stop illness if given to a person soon after they’ve contracted the virus.
There is only a limited supply of these vaccines available, though, so they ideally should be given to people who are most likely to need that protection. So far, vaccines have been offered to people who have been in contact with confirmed infected people, which is known as a ring vaccination strategy. But the expected rise in cases may lead other countries to adopt the UK’s expanded vaccine program.
For what it’s worth, the UK’s decision has been endorsed by Stonewall, Europe’s largest LGBT rights charity organization.
“While we know anyone can catch monkeypox, we welcome the vaccine being offered to those gay and bi men who are eligible and currently at a higher risk of getting the virus,” said Robbie de Santos, Director of Communications and External Affairs at Stonewall, in a statement Tuesday.