Monkeypox

Monkeypox is a rare infection most commonly found in west or central Africa. There has recently been an increase in cases in the UK, but the risk of catching it is low.

Following the UKHSA announcement of further monkeypox vaccines availability, south east London’s health and care system is putting plans in place to continue its programme of vaccinating those identified as most at risk. Across south east London our teams have already delivered around 9,000 monkeypox vaccines.

Second doses of the vaccines

Second dose vaccines will be delivered via the main monkeypox vaccination clinic sites, in particular at Guy’s and St Thomas’ NHS Foundation Trust, and at Lewisham and Greenwich NHS Trust. The roll-out of second doses will start during early October 2022. If you have had a first dose of the vaccination against monkeypox the NHS will contact you directly so you can book an appointment for a second dose of the vaccine.

First doses of the vaccine

We continue to focus on getting first doses to people in the high risk groups who have not been vaccinated.

If you are in a high risk group and have not had any vaccination against monkeypox please contact the Guy’s and St Thomas’ NHS Foundation Trust vaccines clinic service: 0207 188 4040 or covidvaccinebookings@gstt.nhs.uk to arrange a vaccination.

Further information

These processes follow the guidance provided by the Joint Committee on Vaccination and Immunisation (JCVI). The latest statement on vaccine dose prioritisation in response to the monkeypox outbreak can be read here.

Please read the Frequently Asked Questions (FAQs) for more information. The JCVI has also published its latest Technical Briefing.

Frequently Asked Questions (FAQs)

Updated: 28 September 2022

What is the best protection against monkeypox?

The most effective way to protect yourself from monkeypox is to get vaccinated.

A smallpox (Modified Vaccinia Ankara (MVA)) vaccination is being offered to people who are most at risk. To offer as wide-scale community protection as possible only one dose of the vaccine is currently being offered to those eligible. It is expected that second doses will be offered when possible.

The vaccination does not guarantee protection against monkeypox, but it is effective at reducing the likelihood of symptomatic infection and severe illness.

It is important to remain vigilant to monkeypox symptoms even when vaccinated.

More information on the vaccine can be found in the UK Health Security Agency’s (UKHSA) Monkeypox Vaccination Strategy: https://www.gov.uk/guidance/monkeypox-outbreak-vaccination-strategy

How is the vaccine administered?

The MVA vaccine has primarily been either a subcutaneous or intramuscular injection – this means below the skin or into the muscle. However, there is evidence that administering the vaccine between the layers of skin offers the same protection with a lower dose.

On 22 August 2022, UKHSA announced a pilot scheme offering intradermal administration of the vaccine. The safe and clinical approach, also known as ‘fractional dosing’, involves injecting a lower quantity of the vaccine at an angle into the skin which offers the same level of protection.

Following this successful pilot, UKHSA has confirmed that intradermal vaccination will now become the usual method and this will be implemented at south east London monkeypox vaccination clinics. This is the same technique used to administer the BCG vaccine for tuberculosis (TB)

How can I get vaccinated?

The NHS will call forward those that are eligible for vaccination. Second doses will be offered from around 2 to 3 months after the first dose to maximise protection.

The groups currently being offered vaccination based on UKHSA guidance are:

  • Gay, bisexual, and other men who have sex with men at highest risk of exposure – this includes those who have multiple sexual partners, participate in group sex, or attend sex on premises venues.
  • Healthcare workers, including front line staff in sexual health clinics who are assessing any suspected cases.
  • People who have already had close contact with a patient with confirmed monkeypox.

If you are in a high risk group and have not had any vaccination against monkeypox please contact the Guy’s and St Thomas’ NHS Foundation Trust vaccines clinic service: 0207 188 4040 or covidvaccinebookings@gstt.nhs.uk to arrange a vaccination.

If you have received a first dose, the NHS will contact you directly to arrange a further vaccination as set out above.

If you have a scheduled vaccination appointment you should still attend, unless told otherwise.

Post-exposure vaccination is only being reserved for those close contacts who are at highest risk of severe illness – people with immunosuppression, children under the age of 5 years and pregnant women.

Why has there been there a delay?

The current monkeypox outbreak is global and cases have been identified in over 85 countries. In response, there has been a sudden global demand for the smallpox vaccination.

Furthermore, the World Health Organisation (WHO) officially declared smallpox eradicated in 1980. As a result, manufactures of the smallpox vaccine are not equipped to rapidly increase production at such short notice. The UKHSA have overseen the procurement of the vaccine for the UK.

How can I get vaccinated when supply is available?

The current process distributes vaccine to those most at risk of transmitting monkeypox.

NHS trusts have identified those who meet this criterion and will contact individuals by text and/or telephone to book an appointment for their vaccination.

If you have received a first vaccination, please wait to be contacted for your next (second dose) vaccination appointment.

If you are in one of the following groups and have not had a first dose vaccination please contact the Guy’s and St Thomas’ NHS Foundation Trust vaccines clinic service: 0207 188 4040 or covidvaccinebookings@gstt.nhs.uk to arrange a vaccination.

The UKHSA currently recommends the vaccine is offered to these groups first:

  • Gay, bisexual, and other men who have sex with men at highest risk of exposure – this includes those who have multiple sexual partners, participate in group sex, or attend sex on premises venues.
  • Healthcare workers, including front line staff in sexual health clinics who are assessing any suspected cases.
  • People who have already had close contact with a patient with confirmed monkeypox.

More information on the vaccination priority groups and roll out can be found here: https://www.gov.uk/government/publications/monkeypox-vaccination-resources/monkeypox-waiting-for-your-vaccination

The Joint Committee on Vaccination and Immunisation (JCVI)’s statement on vaccine dose prioritisation in response to the monkeypox outbreak can be read here

What can I do to protect myself, and partners, until the vaccine supply increases?

Whilst the best protection is getting vaccinated, there are risk reduction behaviours which can be adopted until the vaccine supply increases.

By adopting the suggestions below, on their own or in combination (recommended), you will reduce the likelihood of getting monkeypox. The suggestions should be considered based on which best suit your lifestyle and need.

  • Consider reducing your number of sexual partners or ‘take a break’ – there is evidence that the current outbreak is being spread during sex and within gay and bisexual sexual networks. Reducing the number of sexual partners or even taking a break until you are able to get vaccinated should be considered although this strategy may not be appropriate for everyone. Monkeypox is NOT sexually transmitted and wearing a condom will not stop you getting monkeypox. Transmission has been linked to the intimacy and close contact occurring whilst having sex.
  • Contact tracing – If you are hooking up with someone new, please consider sharing details so that you can get in touch if you develop symptoms later. Although it is appreciated this is not always possible.
  • Remain vigilant to monkeypox symptoms – Check your body for any unusual blisters, spots, or rashes as this may be monkeypox. If possible, encourage sexual partners to do the same before having sex. If you suspect you have monkeypox you should call 111 or your local sexual health clinic. More information on monkeypox symptoms can be found at https://www.nhs.uk/conditions/monkeypox
  • Do not share bedding or towels with people who are unwell and may have monkeypox.

More information and links

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