Virginia expands monkeypox vaccine eligibility

More Virginians will be able to receive the monkeypox vaccine after the state expanded eligibility as a result of federal changes to how the shots can be administered.

On Thursday the Virginia Department of Health announced the vaccine will now be available to people of any sexual orientation or gender who have had anonymous or multiple sexual partners in the past two weeks, sex workers of any orientation or gender and staff of any sexual orientation or gender at establishments where sexual activity occurs.

Previously, doses were mostly only available to people who were close contacts of laboratory-confirmed cases. Several health departments, including Fairfax, Arlington and Richmond-Henrico, also developed “expanded” eligibility for people considered at higher risk of exposure.

The Virginia Department of Health said the expansion is aligned with current vaccination criteria laid out by the federal Centers for Disease Control and Prevention.

Logan Anderson, a public information officer with the Virginia Department of Health, said the state was able to expand vaccine eligibility because of a recent federal authorization of a new method of administering the shots that allows more doses to be obtained from each vial.

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“We now have up to five vaccinations per vial rather than just one,” he said in an email. The new method “allows for more people at intermediate or high levels of exposure risk to be protected.”

The monkeypox vaccine, a drug known as JYNNEOS developed by a Danish manufacturer to treat smallpox, has traditionally been administered subcutaneously, or under the layers of fat in the arm.

Earlier this month, however, the U.S. Food and Drug Administration issued an emergency use authorization for JYNNEOS to be administered intradermally, or just under the skin, to individuals aged 18 and older. The change increased the total number of doses available for use fivefold.

“In recent weeks the monkeypox virus has continued to spread at a rate that has made it clear our current vaccine supply will not meet the current demand,” FDA Commissioner Robert M. Califf said at the time. By increasing available doses, he added, “more individuals who want to be vaccinated against monkeypox will now have the opportunity to do so.”

Anderson said that all 35 of Virginia’s local health districts will be rolling out intradermal administration by Aug. 29.

“Whereas before 1 vial equaled 1 dose for 1 person, now 1 vial equals up to 5 doses for up to 5 persons,” he wrote in an email. “The smaller amount of vaccine administered intradermally produces the same immune response as the larger dose administered subcutaneously.”

People being vaccinated with JYNNEOS receive two doses of the drug, and the Department of Health said Thursday it is managing the state’s supply “to ensure second doses are available.”

As of Aug. 23, VDH has received 15,282 vials of JYNNEOS. The agency said it has redistributed 8,899 vials to state health districts and administered 5,875 vials through local health departments and other health care providers.

To date, Virginia has recorded 295 cases of monkeypox. Of those, 183 have occurred in the Northern Health Region, an area encompassing the cities of Alexandria, Fairfax, Falls Church, Manassas and Manassas Park and the counties of Arlington, Fairfax, Loudoun and Prince William.

While anyone can catch monkeypox, a virus that causes a contagious skin rash and is spread through close contact, most of the cases that have occurred in the current global outbreak have been among people who identify as gay or bisexual or men who have sex with men.

“There’s no question that gay and bisexual men is the population that’s primarily impacted by monkeypox at this moment,” said James Millner, director of nonprofit Virginia Pride. “That’s where we need to stay focused.”

No deaths linked to monkeypox have been reported. Symptoms include the characteristic rash, as well as fever, headache, muscle aches and swollen lymph nodes.

Millner praised Virginia’s expansion of eligibility to the three new categories of people who have recently had sex with anonymous or multiple sexual partners, sex workers and staff in establishments where sexual activity occurs.

“What I really appreciate is this reflects what the data is showing,” he said. In particular, he said the expansion acknowledges that the virus is primarily being spread by sexual transmission.

“It’s clear that this expansion is not based on a whim. It’s based on the data that we have right now, and that’s how these decisions should be made,” he said.

by Sarah Vogelsong, Virginia Mercury
August 25, 2022

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