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HSE says 6,000 at risk of monkeypox virus but just 600 will get vaccine in first phase of roll out


Monkeypox vaccine: Photo by AP

Monkeypox vaccine: Photo by AP

Monkeypox vaccine: Photo by AP

Around 6,000 people in Ireland may be at “heightened risk” of monkeypox infection but limited supplies of vaccines mean the rollout to reduce the chance of infection will be confined to only 600 in the first phase, the HSE said today.

It will have to carry out vaccination on a phased basis beginning with people who had syphilis between December and July.

It said that some people at high risk of contracting monkeypox will be offered a vaccine against the disease “in the next few weeks”.

The HSE said given the current limited vaccine supply, and following detailed clinical discussions it will prioritise the vaccine for gay and bisexual men, men who have sex with men and transgender people who have had early infectious syphilis between December 2021 and July 2022.

It estimates that around 6,000 people may be at heightened risk of monkeypox infection but current vaccine supplies will allow for the vaccination of just 10pc of them in the first phase of the vaccine rollout.

The National Immunisation Advisory Committee (Niac) advised to vaccinate at-risk people before they are exposed to the virus but supplies of the smallpox vaccine have been limited and are delaying the roll out. More than 100 cases of monkeypox have been diagnosed here this year.

The HSE said today it sought the advice and guidance of clinical and ethical experts to develop a plan for the initial offer of the limited supply of vaccines currently available. It has also engaged closely over the last number of weeks with advocacy and support groups to seek their input into the plan.

“The HSE estimates that around 6,000 people may be at heightened risk of monkeypox infection,” it said.

”Current vaccine supplies will allow vaccination for around 10pc of these individuals in the first phase of the vaccine rollout. The HSE has developed a process of prioritising people for vaccination.

“At this time, supplies of vaccine in Ireland and in the EU are low and limited. Ireland, along with other EU countries is actively exploring options to increase our medium to long-term supply of vaccines. Based on current indications in relation to global supplies of vaccines the second phase of vaccine roll out in Ireland is likely to commence later this year and into next year.

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"To date, the HSE has been offering vaccine to those who are close contacts of cases of monkeypox following assessment by public health and these people have been contacted and invited for vaccination.

“Given the current limited vaccine supply, and following detailed clinical discussions the HSE will prioritise the vaccine for gbMSM and transgender people who have had a notification to the HSE’s Infectious Disease Monitoring system, of early infectious syphilis (EIS) between December 2021 and July 2022.

“As part of the HSE prioritisation process detailed and pragmatic analysis was undertaken which identified this group as including some of those at the highest risk, apart from close contacts of a confirmed case. We reviewed UK data on monkeypox cases and also included learning from programmes recently established in other countries.

“This group is being prioritised because the nature of the spread of syphilis is similar to that of monkeypox, and syphilis also disproportionately affects gbMSM when compared to other STIs. In addition, the majority of these patients are diagnosed through sexual health clinics which means that people can be more quickly identified and invited for vaccination. People in this group will therefore be prioritised in the first phase of the monkeypox vaccinations process.

“The HSE is working closely with infectious disease and genitourinary medicine consultants and the clinical teams in STI clinics around the country to quickly put a process in place to identify and call forward these people for vaccination. In this first phase of the pre-exposure vaccination programme, the STI teams will offer approximately 600 people, two doses of the vaccine – 28 days apart as per the Niac guidelines. Services will begin to contact these people directly in the coming days and it is expected that people identified will receive the vaccine over the coming weeks. The confidentiality of these individuals will be protected.

“Separately, the HSE will ensure that it maintains a supply of vaccine which will be available for those intermediate and high-risk contacts of a confirmed case.”

It said that monkeypox does not spread easily between people and can affect anyone, regardless of their sexual orientation or gender. However by far the biggest risk of spread between people is through close physical contact, including sexual contact and close contact with household members.

Vaccination does not guarantee that a person cannot become infected and those who are vaccinated should continue to be alert to the signs of monkeypox infection.

“Currently notified cases of monkeypox in Ireland are in people who self-identify as gbMSM. As the virus spreads through close contact, the HSE is advising those who self-identify as gbMSM to be alert to any unusual rashes or vesicular lesions on any part of their (or their partner’s) body, especially their genitalia. If they do notice any such changes, they should contact their local STI clinic or their General Practitioner (GP) for advice. Currently, the number of new monkeypox cases in Ireland, week on week, is stable.”

In response HIV Ireland said it welcomed the publication by the HSE of a first-phase roll out of monkeypox vaccine for some people identified as most in need. However it called on the Government to take urgent action to procure additional vaccine stock as the current supply falls far short of what is required.

Welcoming today’s announcement, HIV Ireland executive director Stephen O’Hare said: “A key component to controlling and hopefully eradicating this virus is a coordinated vaccine rollout programme for those most at risk of infection.”

“As the extent of the crisis unfolds, it will be imperative that additional vaccines are procured as soon as possible, and that more resources are made available within sexual health services to identify and contact those most at risk to offer them a vaccine at the earliest opportunity,” he added.

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