Does the clinical approach to human Monkeypox virus infection include vaccination?
yes. Vaccination against the Monkeypox virus is a measure that aims to interrupt chains of transmission of the virus in the face of an epidemiological situation. The vaccine has the potential to prevent and/or attenuate the clinical manifestations of this infection, and may also reduce its infectivity.
Is the Monkeypox virus vaccine available in Portugal?
yes. To prevent infection by the Monkeypox virus, the JYNNEOS® vaccine, a third-generation vaccine against smallpox, also authorized for the prevention of human infection by Monkeypox virus, is authorized in Portugal as an additional measure in the control of the outbreak of human infection by the virus.
Can any citizen be vaccinated?
No. In Portugal, the vaccination strategy against the Monkeypox virus foresees the use of the vaccine in:
- groups at increased risk of human infection by the Monkeypox virus, in the context of preventive vaccination
- people who have had close contact with a confirmed case of infection, i.e. in the context of post-exposure vaccination to the virus
What are the criteria for being vaccinated?
Currently, the vaccine is intended to prevent human infection with Monkeypox virus in people over 18 years of age and without a history of previous infection. The criteria for administration are:
- Groups at increased risk of infection, by means of a declaration of eligibility:
- men who have sex with men, women and transgender people, in pre-exposure prophylaxis for HIV with a history of multiple sexual partners, in the last 6 months< /> men who have sex with men and transgender people, who live with HIV, and have multiple sexual partners, in the last 6 months
- Men who have sex with men and transgender people involved in commercial sex
- Men who have sex with men and have severe immunosuppression
- health workers at high risk of exposure, involved in the collection and processing of biological products from cases of virus infection
- close contacts with confirmed cases of human infection with Monkeypox virus:
- Asymptomatic people with no previous history of infection, with close contact of a confirmed case should ideally be vaccinated within 4 days of the last exposure, and can be vaccinated up to 14 days if they remain symptom-free and if the case to which the person was exposed is probable or confirmed
Where can I request the declaration of eligibility to be vaccinated?
If you meet the above-mentioned preventive vaccination criteria, you can apply for a declaration of eligibility as part of:
- pre-exposure prophylaxis (PrEP) consultations for HIV
- HIV treatment
- treatment of sexually transmitted infections (STIs) in the specialties of infectious diseases or/dermato-venereology
- medical consultations in community-based/non-governmental organizations for key populations
- Occupational Health/Occupational Medicine consultations for health professionals
In cases of post-exposure vaccination, the declaration of eligibility for vaccination is issued by the health authority, commonly known as a health delegate.
What is the vaccination schedule for preventive vaccination?
The vaccination schedule in a preventive context is complete with:
- two doses, for people with no history of smallpox vaccination, with an interval of at least 28 days between doses
- one dose, for people with a history of smallpox vaccination, if the vaccine was given more than 2 years ago OR if it was given less than 2 years ago, but the vaccination schedule was incomplete
What are the indications for the post-exposure vaccination schedule?
If you have been in contact with an infected person, post-exposure vaccination is a priority and should not be delayed. If there is no history of smallpox vaccination, the vaccination schedule should be:
- two doses in people with continuous or intermittent exposure to the virus, with an interval of at least 28 days between doses
- one dose in people without continuous or intermittent exposure
If you have previously been vaccinated against smallpox, it is recommended to take:
- one dose, if the vaccine was given more than 2 years ago OR less than 2 years ago, but with an incomplete vaccination schedule
When should vaccination be carried out?
Vaccination against the Monkeypox virus should ideally take place within the first 4 days after the last contact.
It can also occur up to 14 days after the last exposure, if the person remains symptom-free (asymptomatic) and if the case to which the person was exposed is probable or confirmed.
I had the smallpox vaccination less than 2 years ago. Can I get the Monkeypox virus vaccine?
People with a history of smallpox vaccination (complete schedule – two doses), for 2 years or less, have no indication for this vaccine.
I have already been infected with the Monkeypox virus. Can I get vaccinated?
Nope. People with confirmed prior human infection with the Monkeypox virus are not eligible for vaccination.
What precautions should I take before getting vaccinated?
Before getting vaccinated, you should take the following precautions:
- history of anaphylactic reaction to a previous dose, to any of the constituents of the vaccine, or to substances that may be present in trace amounts. If there is a history, it should be referred to immunoallergology consultation for investigation
- severe acute illness, with or without fever should wait until full recovery
- People with atopic dermatitis may experience exacerbation of symptoms such as redness, swelling, chills, headaches
people who have a diminished immune response (immunocompromised) - Women pregnant or breastfeeding women should not be vaccinated without medical evaluation and prescription
- Minors should not be vaccinated without medical evaluation and prescription
Can pregnant or breastfeeding women be vaccinated?
There are no data on vaccine use during breastfeeding and data on pregnant women are limited. Therefore, if the expected benefits outweigh the potential risks, preventive or post-exposure vaccination should be considered, upon medical prescription, at any gestational age, after an individual assessment by the physician monitoring the pregnancy. The same applies to the breastfeeding woman.
I am a minor. Can I get vaccinated?
If, after a medical evaluation, the expected benefits outweigh the potential risks, vaccination against the Monkeypox virus, in the pediatric age, i.e. in people under 18 years of age, including those who are still breastfed, may be considered, upon prescription of the doctor who carried out the individual evaluation.
Can the vaccine cause adverse reactions?
The most common adverse reactions are:
- In healthy adults never vaccinated with a smallpox vaccine:
- pain, redness, swelling, stiffness, or itching at the injection site
- muscle aches and pains
- headache
- fatigue
- nausea
- Chills
- In healthy adults previously vaccinated with a smallpox vaccine, the most common adverse reactions are:
- redness, pain, stiffness, swelling or itching at the injection site
- fatigue
- headache
- muscle aches and pains
All adverse reactions should be reported to the INFARMED RAM Portal, to be monitored. Alternatively, the following contacts can be used:
- INFARMED, I.P. – Directorate of Medicines Risk Management: (+351) 217987373 and/or farmacovigilancia@infarmed.pt
- Drug Line (free): 800222444
Where can I go to get vaccinated?
If you are eligible to be vaccinated, please refer to the vaccination sites available by appointment.
Source: Directorate-General for Health