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Monkeypox Vaccination

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If you are concerned that you might have been exposed to monkeypox, or are at a high risk for infection, vaccines may be available through your local health department. These vaccines were originally developed for protection against smallpox and may protect you from getting sick with monkeypox if given soon enough after your exposure.

To get more information on available vaccines, you should contact your healthcare provider or local health department:
https://www.dshs.texas.gov/regions/lhds.shtm

More information on the vaccines used to protect against monkeypox virus can be found from the CDC:
https://www.cdc.gov/poxvirus/monkeypox/considerations-for-monkeypox-vaccination.html

Information for Regional and Local Health Departments on vaccine allocation:

The federal government has allocated JYNNEOS vaccine to Texas for the prevention of monkeypox. JYNNEOS is a two-dose vaccine, so half the doses must be reserved to give people a second dose 28 days after the first.

DSHS has distributed vaccine to local health departments and DSHS public health regions based on the number of people currently at the greatest risk of being exposed to the monkeypox virus.  DSHS has also provided  updated guidance to local health departments, including on the population eligible for vaccination.

 Date Doses
 July 23 14,780
 July 29 16,720
 August 15 25,100

Please note that the federal government authorized a new way to administer the vaccine for most adults in early August that uses less vaccine per dose. Prior to that time, one vial contained one dose to be injected beneath the skin. In mid-August the allocation changed because each vial can now be used to inject five doses within the skin. The counts above reflect the number of doses at the time of the allocation to the state. Due to various factors, it may not be possible to get five doses out of every vial.

On August 9, 2022, the Food and Drug Administration issued an emergency use authorization (EUA) for the JYNNEOS vaccine to allow intradermal injection for individuals 18 years of age and older who are determined to be at high risk for monkeypox infection. The EUA now allows for a fraction of the JYNNEOS vaccine (0.1 mL) to be administered intradermally increasing the doses available up to 5 doses per vial. The EUA also allows for use of the vaccine in individuals younger than 18 years of age determined to be high risk of monkeypox infection; in these individuals 0.5 mL of JYNNEOS vaccine is administered by subcutaneous injection. Subcutaneous administration is also recommended for individuals with a history of keloid scars. The vaccine for all individuals remains a 2-dose series given four weeks (28 days) apart.

The Centers for Disease Control and Prevention has endorsed this new route of administration. Providers should administer JYNNEOS intradermally to eligible individuals 18 years older effective. Please ensure staff administering the vaccine have proper training on intradermal vaccine administration.

People with a known or possible exposure to the Monkeypox virus remain the highest priority for vaccination. Local health entities may also expand vaccination to include pre-exposure prophylaxis (PrEP) for people who are at an increased risk of Monkeypox, such as people 18 years of age and older who:

  • are men who have sex with men, and
  • have had multiple or anonymous sex partners within the previous 21 days.

DSHS further recommends prioritizing eligible people who:

  • have a sex partner who is showing symptoms of monkeypox, such as a rash or sores,
  • have had a diagnosis of HIV, chlamydia, gonorrhea, or early syphilis, within the previous 12 months,
  • are on HIV pre-exposure prophylaxis, or
  • have a condition that may increase their risk for severe disease if infected with monkeypox virus, such as HIV, atopic dermatitis, or eczema.

Local health entities should consider any outbreak in their communities, the number of doses on hand, and the timing of future deliveries as they determine whether and how to implement PrEP. As you do so, please:

  • Ensure to maximize doses available by using the newly authorized 5 doses/per vial intradermal administration.
  • account for second doses within the current allocation,
  • hold some doses specifically for post-exposure prophylaxis and outbreak response.

Finally, it is critically important that all providers report doses administered in VAOS and ImmTrac2 (if consented) within 24 hours of vaccination:

As always, report any adverse events into the Vaccine Adverse Event Reporting System known as VAERS.

Last updated September 16, 2022