Australia Recommends Monkeypox Vaccines For Some Gay, Bisexual Men

The Australian Technical Advisory Group on Immunisation (ATAGI) has recommended monkeypox vaccines for key risk groups, including gay, bisexual and men who have sex with men who are at high risk of exposure.

ATAGI also updated its earlier guideline and in addition to the ACAM2000 vaccine, it has recommended the use of JYNNEOS (MVA-BN) vaccines for monkeypox.

Following the update to the vaccination guidelines, Australia’s chief medical officer Professor Paul Kelly on Thursday declared monkeypox as a “Communicable Disease Incident of National Significance”. 

As of July 28, 2022, around 20,311 monkeypox cases have been reported in 71 countries, outside of Central and West Africa where the disease is endemic. This includes 44 monkeypox cases in Australia, a majority among returned international travellers. Last week, the World Health Organisation had declared monkeypox a global health emergency. 

Health authorities have repeatedly emphasised that monkeypox is not a “gay disease”. The current outbreak reported mainly among gay, bisexual and men who have sex with men has been attributed to the community getting tested for sexually transmitted infections at any sign of symptoms.

LGBTQI Community Welcomes ATAGI Recommendations

LGBTQI leaders and organisations in Australia had urged the government to approve and secure supplies of the monkeypox vaccine and offer it to gay, bisexual and men who have sex with men and other at risk individuals.

Thorne Harbour Health welcomed the ATAGI updation of monkeypox vaccine guidelines adding that there was a small “window of opportunity” to get things right. 

“Given that gay and other men who have sex with men account for all cases identified in Australia so far, we welcome the ATAGI guidance regarding key risk groups and the recommendations regarding vaccination,” Thorne Harbour Health’s Director of Health Promotion, Policy and Communications Colin Batrouney told Star Observer.

“There is a high level of interest and motivation within the community regarding vaccination for this preventable disease. Of course we are talking about a community that is habituated to maintaining vigilance related to sexual health and wellbeing, a community that is mobilized around their own safety and the safety of others,” said Batrouney. 

Far Less Harmful Than COVID-19

Professor Kelly said that monkeypox was “far less harmful than COVID-19” and “far less transmissible”. No deaths have been reported in the current outbreak outside of the countries where it is endemic. 

“Most cases of MPX in Australia have been among people aged 21 to 40 years. The experience internationally and in Australia to date is most cases have been among gay, bisexual and other men who have sex with men,” said the chief medical officer. 

Professor Kelly said that though monkeypox was not a sexually transmissible infection, “physical contact with an infected person during sexual intercourse carries a significant risk of transmission and intimate physical contact such as hugging, kissing and sexual activities represent a risk of infection, with infectious skin sores being the likely mode of transmission.”

Australian Government Urged To Approve Monkeypox Vaccines For Gay & Bisexual Men

ATAGI On Monkeypox vaccines

ATAGI has identified five key risk groups for whom monkeypox vaccines are recommended including, gay, bisexual and men who have sex with men (GBMSM) “who are at the highest risk of monkeypox infection due to having a high number of sexual contacts”.

GBMSM who are living with HIV, have a recent history of multiple sexual partners, participating in group sex or attending sex on premises venues, or are on PrEP are eligible to receive the monkeypox vaccine. 

“Wider vaccination of low-risk gay, bisexual and men who have sex with men or the general population is not recommended at this time, due to the current epidemiology, low risk of infection and limited vaccine supply,” ATAGI said. 

The other key risk groups include sex workers, anyone categorised as a high risk monkeypox contact and immunisation providers. ATAGI has also recommended that those in the key risk groups planning to travel to a country which is experiencing “significant outbreak” should get vaccinated four to six weeks before departure. 

What Are The Monkeypox Vaccines Available in Australia?

There are two monkeypox vaccines available in Australia, third generation JYNNEOS and second generation ACAM2000. 

ATAGI said that limited supplies of third generation JYNNEODS have been secured by the federal government and some states and territories. 

“Overall, JYNNEOS is the preferred vaccine for both pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), due to its more favourable safety profile and comparative ease of administration,” ATAGI said. 

For those who have received a smallpox vaccine more than a decade ago, a booster is recommended. “Prioritisation for PrEP should take into account supply considerations, with at-risk population groups receiving priority over other groups, such as healthcare workers and laboratory workers, if supply is constrained,” said ATAGI. 

US Gay Man Shares His Monkeypox Diagnosis In Viral TikTok Video

One of the challenges is the availability of the vaccines in required numbers. “We understand that there will be limited access to the Jynneous vaccine initially, so strategic targeting of those at risk of infection will be critical in the rollout and implementation of the vaccine program. In addition, consultation with community in relation to the vaccine rollout will be critical to its success,” said THH’s Batrouney. 

“We have a window of opportunity with regard to control of monkeypox that is closing. We need to get government to act expeditiously to secure vaccine supplies and work with the states and territories to implement vaccine rollout as soon as possible,” added Batrouney. 

What Is Monkeypox?

The current outbreak of monkeypox was first reported in May 2022. “Monkeypox’s rash and flu-like symptoms are relatively mild, and in most cases, resolve themselves within two to four weeks without the need for specific treatments,” said Professor Kelly. 

According to Professor Kelly, the rash first appears on the face, before spreading to other parts of the body, including palms of the hands and soles of the feet. 

“However, in this outbreak it is being seen especially on the genital and perianal regions of affected people,” said Professor Kelly, adding, “The rash can vary from person to person and take on the appearance of pimples, blisters or sores. The flu-like symptoms often include fever, chills, body aches, headaches, swollen lymph nodes and tiredness.”

The chief medical officer said that monkeypox treatments like antivirals were available with the National Medical Stockpile and states and territories could access it on request.