Sexual Health – Science – Vaccination

Is there a vaccine against monkeypox?

The Modified Vaccinia Ankara - Bavarian Nordic (MVA-BN) vaccine can be used to protect against monkeypox. It also offers protection from diseases caused by the smallpox and vaccinia viruses. The MVA-BN vaccine is called by the brand name Imvanex in Europe and Jynneos in the United States. The manufacturer is Bavarian Nordic. During this outbreak both Imvanex and Jynneos are being used in Europe.

Who can get a monkeypox vaccine now?

You may be offered a vaccine if you are a close contact of someone who has monkeypox. Public health will let you know if you should get a monkeypox vaccine. Some people at high risk of exposure to monkeypox are also being offered the monkeypox vaccine. Visit the HSE website to check if you are recommended a monkeypox vaccine and book your vaccination appointment. You may also be referred by a healthcare professional. At this time, the monkeypox vaccine is not considered necessary if you have had monkeypox infection before.

How is the monkeypox vaccine administered?

There are two ways to give the vaccine.

• It is given by injection into the upper arm (subcutaneous).

• The vaccine may also be given between layers of skin (intradermal). With the intradermal route, available evidence suggests you need a smaller volume of vaccine to get similar protection from monkeypox.

If you are under 18 years or have had keloid scars in the past the vaccine will be given as a subcutaneous injection and not intradermally. Experts from the National Immunisation Advisory Committee and European Medicines Agency have advised that both ways of giving the vaccine are safe and are expected to offer similar protection from monkeypox.

How does the monkeypox vaccine work?

The vaccine prepares the body to defend itself against infection with monkeypox virus. It contains a weakened, non-replicating form of the vaccinia virus called ‘modified vaccinia virus Ankara’, a virus that is closely related to the smallpox and monkeypox viruses but does not cause disease in humans and cannot reproduce in human cells. Due to the similarity between the vaccine and these viruses, antibodies produced against it are expected to protect against monkeypox, smallpox and vaccinia.

What are the common side effects after getting the vaccine?

Like all medicines, vaccines can cause side effects. Most of these are mild to moderate, short-term, and not everyone gets them. The most common side effects of the vaccine (which may affect more than 1 in 10 people) are headache, nausea, myalgia (muscle pain), tiredness and injection site reactions (pain, redness, swelling, hardening and itching). Please report any side- effects from this vaccine to Health Products Regulatory Authority at www.hpra.ie. You can report it yourself or your doctor or family member can do that for you.

Is it common to get a lump at the vaccination site?

If your vaccine is given between layers of skin (intradermally) it is very common to notice a small lump or a change in the colour of your skin where the vaccine was given. This can last for several months. This is very common after people have had a second dose.

What measures are being taken to ensure the safety and effectiveness of the monkeypox vaccine?

As for all medicines, data on the use of the vaccine are continuously monitored. Side effects reported with vaccine are carefully evaluated and any necessary action taken to protect people.

Who should not get the vaccine?

You should not get the vaccine if you have had a serious allergic reaction to any of the ingredients in the vaccine (including chicken protein, benzonase, gentamicin, ciprofloxacin and Trometamol). Read the manufacturer’s Patient Information Leaflet to see the list of ingredients. You can also find a link to the patient information leaflet for the Imvanex vaccine at www.hpra.ie. At this time, the monkeypox vaccine is not considered necessary if you have had monkeypox infection before.

How many doses of monkeypox vaccine will I get?

If you are identified as a close contact and have been exposed to monkeypox, you will get one dose of the monkeypox vaccine. Some close contacts may be offered a second dose. If you are getting the vaccine because you are at high risk of getting monkeypox, you will get two doses of the monkeypox vaccine, 28 days apart. If you had a smallpox vaccine before, you only need one dose of the vaccine. However, if you have a weak immune system, you will need two doses.

Like with all vaccines, the monkeypox vaccine may be less effective for you if you have a weakened immune system.

Will I be protected against monkeypox after vaccination?

It takes 14 days after your course of this vaccine for it to work. After you have been fully vaccinated, there is a chance you might still get monkeypox infection. If you do get monkeypox infection despite getting vaccinated you may have reduced symptoms of monkeypox infection.

Why can I have a COVID-19 vaccine before but not until four weeks after?

With some COVID-19 vaccines there is a very rare risk of inflammatory heart conditions after receiving the vaccine that have mainly occurred within 14 days of receiving the vaccine. We find such very rare risks when the vaccines are used in a large number of people. The MVA-BN vaccines have not been used widely so we do not know if they could cause inflammatory heart conditions. Therefore, NIAC have advised that there should be an interval of four weeks between monkeypox/smallpox vaccine and a subsequent COVID-19 vaccine because of the unknown risk of myocarditis (inflammation of the heart muscle). This is a precautionary measure. They have also advised that no interval is required between a COVID-19 vaccine and a subsequent monkeypox/ smallpox vaccine.

How do I reduce my risk of monkeypox if I am at risk and waiting for a vaccine?

For more information about making informed choices about your sex and social life during the monkeypox outbreak visit the MPOWER or Man2Man websites:

https://mpower.hivireland.ie/monkeypox/

https://man2man.ie/monkeypox

If you have a rash, contact your local sexual health clinic. Keep away from other people and do not engage in sexual contact until you have been seen. A list of public STI services is available on the HSE’s Sexual Wellbeing website:

www.sexualwellbeing.ie/sexual-health/hse-sti-services- in-ireland.html

Where can I get more information from?

Talk to a trusted healthcare professional or visit the HSE website:
https://www2.hse.ie/conditions/monkeypox/ 

Read the HSE information leaflet (including translations) at:
https://www.hpsc.ie/a-z/zoonotic/monkeypox/vaccination/ 

Read more FAQs about monkeypox at:
https://www.hpsc.ie/a-z/zoonotic/monkeypox/factsheets/