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CDC encourages mpox vaccination for gay and bisexual men ahead of Pride events

Recent outbreak shows 90% of mpox cases in US were among unvaccinated gay or bisexual men.

In this 2022 photo, Licensed Vocational Nurse Yustina Mikhael, right, administers a dose of the Jynneos mpox vaccine to a person at an Los Angeles County vaccination site. Mpox remains a threat, but vaccines are more readily available. Mario Tama/Getty Images via CNN Newsource

Pride month is here and mpox remains a threat, but vaccines are more readily available

Originally Published: 06 JUN 24 13:43 ET

(CNN) — As the LGBTQ+ community gears up for Pride celebrations this month, the US Centers for Disease Control and Prevention hopes people will get more than just their rainbow gear and sunscreen ready. The agency is urging more people – particularly some gay and bisexual men – to get the mpox vaccine.

The US Department of Health and Human Services plans to be at dozens of Pride and community events across the country to remind people that mpox is still a problem in the United States, but with vaccination, it doesn’t have to be.

Anyone can get sick with mpox, the painful and sometimes deadly disease formerly known as monkeypox. But in the global outbreak that started in 2022, certain members of the LGBTQ+ community are considered especially vulnerable. According to recent case reports, 90% of those who got mpox in the US during this outbreak who reported their sexual orientation were men who identified as gay or bisexual. And nearly all of those who got sick were unvaccinated.

“For folks who have not yet gotten two doses of the Jynneos vaccine, it’s really important for protecting them from this disease,” said Alex Tuttle, an epidemiologist with the Poxvirus and Rabies Branch of the CDC. “About a quarter of the population that we believe is at risk is currently vaccinated, so we really want to push that up, especially as we’re going into these summer months where risk might be heightened a little bit.”

Mpox is a viral disease that can spread easily between people and from infected animals. It can spread through close contact such as touching, kissing or sex, as well as through contaminated materials like sheets, clothing and needles, according to the World Health Organization. Symptoms include a fever, a painful rash, headache, muscle and back pain, low energy and enlarged lymph nodes.

For decades, the disease had largely been found in Central and West Africa, but in the 2022 outbreak, cases also began spreading in Europe and North America.

Case numbers in the US remain stable and are nowhere near as high as in 2022, when WHO declared the outbreak in North America and Europe a Public Health Emergency of International Concern. But there were about 59 new cases a week reported in the US as of the end of April, according to a report published in May, which Tuttle co-authored. By comparison, at the height of the outbreak in 2022, there were about 3,000 new cases reported per week in the US.

Another report published by the CDC Thursday looked at the kinds of patients who were seeking care at their local emergency room for mpox between June and December of last year. Of the 196 patients with rashes that doctors suspected could be mpox, three actually were infected. All three were gay or bisexual men who who engaged in sex with one or more partners that they initially met through dating apps. None had been vaccinated.

Other studies have shown that the vaccine, which is now commercially available, can help keep people safe. A recent report confirmed that two doses of the Jynneos vaccine made by Bavarian Nordic are highly effective in preventing many mpox cases. If someone who was vaccinated did get sick, the vaccine can reduce the severity of symptoms.

There have been scattered reports of infections among vaccinated people, including one cluster in May 2023 in Chicago, but these cases are rare, occurring in less than 1% of cases, the CDC said.

Mpox isn’t just an uncomfortable inconvenience. About 10% of people who got sick with mpox in the US in the latest outbreak were hospitalized, and five have died since October. People with compromised immune systems, particularly those with advanced HIV, have more severe infections, the CDC says.

Another reason to get the vaccine is the threat of a deadlier version of the virus known as clade I, which carries a case fatality rate of up to 10%, compared with 0.1% to 3.6% for clade II, the version currently in circulation in the US. This version of the disease, the CDC said, is also more transmissible. It hasn’t made its way to the US yet, but it is at the heart of an outbreak that the CDC is monitoring in the Democratic Republic of Congo. Tuttle said the Jynneos vaccine should protect against clade I as well as clade II.

“The measures that we have right now, both the vaccine and any of the antivirals, are expected to work on both clade I and clade II of the virus, should it come here,” Tuttle said.

Brian Hujdich, executive director of the National Coalition for LGBT Health, said his organization and others will continue to work hard to encourage mpox vaccination.

“With all the Pride events over the summer and just being summertime, there’s going to be more interaction. And we’ve seen already that there has been an increase in Virginia and in New York City and in some other locations,” he added. “So it might not be in numbers that get a lot of attention, but even a small increase can be a preamble to an outbreak.”

The CDC is working with the HHS Office of the Assistant Secretary of Health, local organizations and community health partners on what it calls the Summer of Pride initiative, which includes a campaign to remind people that although mpox case numbers have declined significantly, the threat has not disappeared.

“I do think some people are surprised that it is still a problem,” said Adrianna Boulin, director of racial equity, social justice and community engagement at Fenway Health, an organization that advocates for and delivers equitable care focused on the LGBTQ+ community. “Last year, we had such a robust program of getting education and information out to people, and we saw mpox rates decline initially, so everyone is surprised, like ‘wow, this is still an issue.’ It’s important for everyone to know about it, because it can impact all of us.”

Boulin, who is also president of Boston Pride of the People, the group that puts on that city’s Pride parade and celebrations on June 8, said there is a health corner at the festival where a number of organizations will talk about the programs and services they offer, including information about the mpox vaccine.

Fenway had been running mpox vaccination clinics when the outbreak started, but as the number of cases declined, fewer people were showing up, so it now offers the vaccine by appointment only.

Across the country, doses have become much more readily available than early in the outbreak, when people had to stand in long lines at special clinics. Now, pharmacies and many regular medical providers have the vaccine.

In addition to the big Pride festival, Fenway Health plans to be at several other LGBTQ events, Boulin said, and at each, workers will talk about mpox.

“People are excited that they’re outside at these events and they’re motivated, they’re open, they’re listening, and so those are all recipes for really getting information out to folks that they need to help their health,” Boulin said.

Key West Pride, which is one of the first of the year and runs from from June 5 to 9, said it will also have a visible health organization presence that will offer educational materials at its Street Fair/Dance Party about mpox and the benefits of the mpox vaccine.

The local department of health also provides resources on mpox and vaccination, he said.

Hujdich said an important message that health organizations will want to emphasize is that mpox vaccines provide not only protection but real peace of mind.

“You don’t have to be worried about being in contact with people if you’ve been vaccinated,” Hujdich said, “So it gives you the freedom to enjoy and be proud during Pride.”

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