PORTLAND, Ore. – Oregon Health Authority (OHA) has expanded its eligibility criteria for the monkeypox (hMPXV) vaccine. It now includes “anyone who anticipates having or has had recent direct skin-to-skin contact with at least one other person AND who knows other people in their social circles or communities who have had monkeypox.”
The new interim monkeypox vaccination guidance for use of the JYNNEOS vaccine was developed with extensive input from community partners, local public health authorities, health care providers and Tribal health organizations, said Tim Menza, M.D., Ph.D., senior health adviser for OHA’s monkeypox response.
“It was a community-based process,” Menza said. “We heard loud and clear that if we wanted to get people in the door to get vaccinated against monkeypox, we needed to rethink how we talked about who is at greatest risk of infection.”
In its vaccine eligibility criteria, the vaccination guidance no longer refers to sexual orientation or gender identity – cisgender men, transgender men, transgender women, and non-binary people who have sex with men – which may have been a barrier for people seeking vaccinations, Menza said. The guidance also clearly states what is known as the most common route of transmission: direct, skin-to-skin contact.
The guidance “no longer calls out specific populations defined by sexual orientation or gender identity. Instead, it calls out the most common route of transmission,” Menza explained. “In doing so, we hope to reduce the stigma associated with eligibility for monkeypox vaccination.”
In addition to encouraging JYNNEOS vaccination for anyone who anticipates having or has had recent skin-to-skin contact with others and shares a social circle or community with someone who had the virus, the guidance continues to recommend the vaccine for other high-risk persons: anyone who had close contact with someone with monkeypox or who local public health staff identified as being a contact of someone with the virus; laboratory workers who routinely perform monkeypox virus testing; and clinicians who had a high-risk occupational exposure, such as from examining monkeypox lesions or collecting monkeypox specimens without using recommended personal protective equipment.
The guidance also encourages vaccine providers to “think creatively” in planning vaccine events, Menza said. For example, it recommends providers work in partnership with community-based organizations or local businesses to offer “venue-based vaccine events” that prioritize communities most affected by monkeypox, which will make vaccines more accessible and acceptable. Venue-based vaccine clinics are those that occur in spaces or at events frequented by people from communities most affected by monkeypox. For example, OHA and partners have been offering vaccines at large community events, nightclubs and bathhouses.
Anyone who requests the vaccine at community-based vaccine events, should receive it, the guidance states.
When possible, vaccine providers should integrate monkeypox vaccine administration with the influenza vaccine, COVID-19 vaccines and boosters, COVID-19 testing, HIV/STI testing, HIV pre-exposure prophylaxis (PrEP) information and referrals, and harm-reduction education and outreach. Combining services will reduce stigma related to receiving a monkeypox vaccine “in that people could come to a vaccine event for one of several services,” according to the guidance.
“We want these events to feel more like a health fair,” Menza explained.
Menza believes the expanded monkeypox vaccination guidance represents a new phase in the state’s response to the outbreak.
“Initially, folks were stepping forward, and we had a lot of demand for the vaccine up front,” he said. “In the last four weeks, since mid-August, we’ve seen a steep drop-off in demand. Wait lists have dropped to zero, and available slots are not being filled. We need to reinvigorate our vaccination campaign and find new ways to get the vaccine to people who most need it.”
News Release from Oregon Health Authority
