Welsh NHS to roll out vaccination programme to those most at risk of monkeypox

Health Minister Eluned Morgan says NHS Wales will roll out a vaccination programme to combat the current outbreak of monkeypox as soon as possible.

She also confirmed the Welsh Government has amended the Health Protection Regulations to make monkeypox a notifiable disease.

This means medical practitioners must notify the relevant local authority of any suspected or confirmed cases of monkeypox.

In addition, diagnostic laboratories will be obliged to report if they identify monkeypox virus as “a causative agent”.

The ministers’ comments come after the UK Health Security Agency (UKHSA) announced plans to control the spread of the virus by offering some gay and bisexual men at higher risk of exposure the smallpox vaccine Imvanex.

The UKHSA said that the jab had been shown to be effective against monkeypox.

Its new strategy, endorsed by the Joint Committee on Vaccination and Immunisation (JCVI), suggests that eligibility would depend on a number of factors but a clinician may advise vaccination for someone who has a “recent history of multiple partners, participating in group sex, attending sex on premises venues or a proxy marker such as recent bacterial STI in the past year”.

Intimate contact

The virus is not currently defined as a sexually transmitted infection, but it can be passed on by close and intimate contact that occurs during sex.

The guidance does not recommend vaccination to the general population.

In a written statement, the minister also confirmed there will be a limited post-exposure vaccination element to the programme for household and sexual contacts of confirmed cases, ideally within four days of exposure, extended to up to 14 days for those who are at an ongoing risk or are at a higher risk of the complications of monkeypox.

An individual’s eligibility would depend on a number of factors but “would be similar to the criteria used to assess those eligible for HIV pre-exposure prophylaxis – but applied regardless of HIV status.”

A number of health workers are already offered the jab, including those who care for people with the virus and lab workers where pox viruses are handled.

The vaccine has also been offered to close contacts of those who have a confirmed case of monkeypox to reduce their risk of symptoms and severe illness.

The health minister said: “Everyone is being asked to be aware of monkeypox symptoms but it’s particularly important gay, bisexual, and other men who have sex with men are alert.”

There have been eight confirmed cases of monkeypox in Wales up to 22 June.

Some 793 cases have been confirmed in the UK.

The current outbreak has largely occurred among gay and bisexual men, according to the UKHSA.

Just five cases have been confirmed in women.

Contact tracing

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.

“In the meantime, everyone should continue to be alert to any new spots, ulcers or blisters on any part of their body, particularly if they’ve had close contact with a new partner.

“If you think you have these symptoms, avoid close contact with others and call NHS 111 or your local sexual health centre, though please phone ahead before attending.”