Dr. Fauci explains why people are not protected from monkeypox
Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, talked to USA TODAY about protection against monkeypox.
Ariana Triggs and Becky Kellogg, USA TODAY
If you've gotten vaccinated for monkeypox, you may befamiliar with "the lump."
Ever since the viral outbreak reached the U.S. this summer, many people have taken to social media to report side effects of the Jynneos vaccine, which can be injected intradermally (into the skin) or throughthe more traditional subcutaneous method (below the skin).
One common complaintis a red bumpat the injection sitelasting for two to three weeks, if notlonger. But experts reassure that it's nota "weird" or "permanent" reaction.
A temporary lump on your armis normal forany vaccination,but "it is particularly expected with the Jynneos vaccine," says Anthony Fortenberry, chief nursing officer at Callen-Lorde Community Health Center. "This is a super common side effect."
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Induration, or an area of hardness at the injection site, is part of the body's immune response to vaccines.
"The body recognizes the viral material as foreign and sends immune cells to react against it,"says Dr. AdityaChandorkar, an assistant professor in the division of infectious diseases and international medicine at the University of Minnesota. "One of the consequences of this reaction (is) some degree of local reaction, leading to a lump/swelling.
"Its important to note that the presence or absence of the swelling is not a marker for how well the person is going to be protected by the vaccine."
Some people have reported tenderness, itching, pain or bruising on or around the lump. "That generally does resolve on its own," Fortenberry says. "You do want to avoid scratching it because that can cause further inflammation, delay healingand also cause infection, so you want to be cautious. And if it's causing pain, the recommendations are over-the-counter Tylenol or Motrin" to help with inflammation.
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"Having a large, painless lump at the site of the injection is fairly common," Chandorkar says. "The original (Jynneos) vaccine studies reported some degree of local swelling in over half of the people who received the vaccine." Anecdotally, "most people have reported the lump going away after a week to two weeks. In almost all cases, the lump should go away by itself, and people should not need to see their physician."
If the bump is still present after more than two weeks, that's no cause for alarm. In fact, it's "really common," Fortenberry says, and should not deter people from receiving their second Jynennos dose four weeks after the first.
"So many people are having inflammation at the site for many weeks," Fortenberrysays. "For inflammation to occur for up to four weeks is such an expected side effect that clinical guidance (at vaccination sites) addresses that, by asking nurses to administer the shoton the other arm."
"Other side effects include muscle pain, headache, fatigue and nausea," Chandorkar says. "Although fevers and chills are reported, they are not the norm. They are only seen in 1% to 10% of patients."
The Jynneos vaccine produces side effects that"are comparable to most other vaccines," he adds. "(Reactionsare) generally far milder than what some experienced with the COVID-19 vaccines."
You should speak to a medical professional ifyou experiencefevers or chills for more than one to two days after getting the Jynneos vaccine,says Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Childrens Hospital and dean of the National School of Tropical Medicine at Baylor College of Medicine.
As for the lump, "if the pain becomes problematic, or if you see the redness worsen or spreading, including streaks of redness, you should contact your doctor," Hotez says.
Fortenberry stresses that severe adverse reactions to the Jynneos vaccine are "extremely rare," but you should call 911 immediately if you experiencedifficulty breathing, hives, swelling of the face or throat, a fast heartbeat, dizziness, or weakness after getting vaccinated.
Although side effects such asthe lump might seem like a nuisance, they're much better than the alternative of getting monkeypox, which is an extremely painful infection with symptomsthat can lasttwo to fourweeks andrequiresquarantine.
"The best way to ensure you won't become infected is to get vaccinated," Hotez says. "Monkeypox, although rarely fatal, is a serious and debilitating infectious disease, and could require hospitalization."
And if you have any fears of potential side effects, don't hesitate to discuss them with medical personnel at your vaccination site.
"They have all the information necessary to provide reassurance and make sure everyone has very clear expectations around the vaccine," Fortenberry says. "We encourage everyone to complete their vaccine series if they're eligible for a second dose. Don't let side effects prohibit you from going back for your second dose and getting full immunity.It's super important to err on the side of reaching out to a medical provider if you have questions or concerns that's what we're here for.
"You don't have to manage this on your own with the internet."
As of Sept. 15, there are 24 monkeypox cases in Douglas County.
Infectious diseases nurse practitioner Nikki Regan, MSN, APRN, NP-C, is leading monkeypox vaccine education and outreach in Nebraska Medicine clinics.
Get answers to the most common questions about the monkeypox vaccine. You can also protect yourself from monkeypox in other ways.
Yes. The JYNNEOS vaccine is approved for prevention of both monkeypox and smallpox. "Smallpox and monkeypox are in the same family of viruses," explains Regan. This vaccine has shown effectiveness in previous outbreaks of smallpox and monkeypox.
"We simply don't have enough to vaccinate the entire population," says Regan. "There's a lot of demand for it, so we're reserving vaccines for people at highest risk."
Monkeypox vaccines are available for the prevention of monkeypox both before and immediately after an exposure:
Post-exposure: You can get the vaccine up to 14 days after close contact with someone with monkeypox. Get the vaccine as soon as possible after exposure to get the best chance of preventing monkeypox or having a less severe illness. "Getting vaccinated within a couple days of exposure reduces the risk of developing monkeypox," says Regan.
Pre-exposure: Pre-exposure prophylaxis or PrEP vaccinations are the majority of vaccinations right now. "Every health department has its own prioritization criteria. Here in the Omaha area, we are prioritizing people at high risk of monkeypox exposure including men or transgender people who have sex with men, especially if they have multiple partners or recent sexually transmitted infections," says Regan. "Check with your local health district to see how it's being distributed in your area."
How to get the monkeypox vaccine: Take the Douglas County Health Department survey. If you are eligible, they will reach out to you about where to get your vaccine. If you live outside of Douglas County, check with your provider or local health department.
The JYNNEOS vaccine is a two-dose series, given 28 days apart.
"The vaccine has a virus that's been weakened so it can't replicate in your body," says Regan. "The weakened virus can't make the person sick, and it can't spread to other people either. The weakened virus is there for the immune system to see it and build some protection against it. Then, if the person is exposed to the real monkeypox virus later, the immune system remembers it and prevents the infection."
That red, raised bump on your arm after receiving the vaccination is perfectly normal. It's not permanent and should go away after several weeks.
The shallow injection of the vaccine causes a wheal, which looks like a small bubble and gradually fades. Providers are giving the monkeypox vaccine intradermally (between the skin) rather than subcutaneously (into fatty tissues) to increase supply. Intradermal injection has increased the vaccine supply fivefold.
"We place a small amount of vaccine right under the top layer of the skin, which causes a wheal kind of like a little bubble," says Regan. "It can be irritating and itchy and sometimes causes bruising, but this is minor and temporary." Other common vaccine side effects include tiredness and headache.
The monkeypox vaccine causes a red, raised bump called a wheal. A wheal shouldn't leave a scar, but it can feel itchy.
In most cases, you can get a JYNNEOS vaccine at the same time you get other vaccines, except the COVID-19 vaccine. If you get the JYNNEOS vaccine, wait four weeks before getting a COVID-19 vaccine.
Yes, the monkeypox vaccine JYNNEOS is free. The federal government is currently distributing the vaccine.
Yes, the vaccine can prevent monkeypox or lessen the severity of your disease if you get vaccinated soon after a known exposure. Ideally, you should get vaccinated as soon as possible ideally within four days, but it can be given up to 14 days after exposure.
You can also get the vaccine before exposure as a preventive step if you're eligible.
JYNNEOS is safe for people with eczema. ACAM2000, a vaccine that is approved for smallpox and available for the prevention of monkeypox under an Expanded Access Investigational New Drug protocol, is a live virus vaccine that is not safe for people with eczema and some other conditions.
"JYNNEOS is the primary vaccine being administered for the current monkeypox outbreak in the United States," says Regan. "ACAM2000 is an alternative vaccine that contains a live replicating virus called vaccinia. It can spread to other parts of your body and other people, so you have to be extra cautious caring for the vaccine injection site."
The ACAM2000 vaccine is not safe for people with these conditions:
CNN
The US Centers for Disease Control and Prevention issued a new warning to health care providers Thursday about severe illnesses in people with monkeypox.
The alert comes as Ohio reported that an individual with monkeypox has died the third known death of a patient with monkeypox in the United States.
Ohio listed the death in an update to its online monkeypox outbreak dashboard Thursday. The Ohio Department of Health on Friday said an adult male with monkeypox had died, and the individual had other health conditions. The CDC told CNN it is aware of the death.
The first US death due to monkeypox was confirmed this month in Los Angeles County. The county public health department and the CDC said the person had a severely weakened immune system and had been hospitalized. No further information will be made public, the department said.
A person in Harris County, Texas, who had monkeypox died in August, but the virus role in that death has not been confirmed.
Deaths from monkeypox are extremely rare, and babies, pregnant women and people with weakened immune systems are at greater risk. Among more than 67,000 cases reported globally in the current outbreak, there have been 27 deaths, according to the World Health Organization.
More than 25,000 cases of monkeypox have been reported in the United States, but recent case trends suggest that the outbreak is slowing in the US.
Falling case numbers might be a reflection of rising numbers of people vaccinated against the virus. This week, the CDC announced that its expanding eligibility for the Jynneos monkeypox vaccine to higher-risk people who have not been exposed to the virus.
According to data posted by the CDC on Wednesday, men at high risk for monkeypox because they have sex with other men or because they live with HIV were 14 times more likely to be infected if they were unvaccinated compared with those who were at least two weeks past their first dose of the vaccine.
The CDC said Thursday that some people in the US who were infected with monkeypox during the ongoing outbreak have had severe manifestations of the illness, extended hospitalizations or substantial health problems.
The agencys health alert notes that severe monkeypox can happen in anyone, and most people diagnosed during this outbreak have had mild or moderate illness. Most people whose illness has been severe have had HIV with substantial immunosuppression, it says.
Some of the severe illnesses have included:
The advisory urges health-care providers to be aware of risk factors for severe monkeypox and says anyone with suspected or confirmed monkeypox should be tested for HIV. Providers should also check whether the persons immune system may be weakened by another condition or by a medication.
Monkeypox treatment in people who have weakened immune systems should involve stopping any medications that may be affecting the immune system, providing antiretroviral therapy for those with HIV, and possibly using medications such as tecovirimat, known as Tpoxx.
The CDC says people who were exposed to monkeypox through sexual contact should get tested for HIV and other sexually transmitted diseases.
The Erie County Department of Health (ECDOH) is offering a monkeypox vaccine clinic for eligible members of the UB community from 11 a.m. to 5 p.m. Oct. 7 at UBs new Student Health Services facility, 4350 Maple Road, Amherst. The clinic is open to UB students, faculty, staff, alumni and others at high risk of exposure to monkeypox.
Appointments are strongly recommended; walk-ins are welcome.
Current New York State monkeypox (Jynneos) vaccine eligibility includes the following New Yorkers:
In addition to UB-hosted clinics, ECDOH is also holding off-campus monkeypox clinics that may be conveniently located for some UB students, faculty and staff.
For a list of these clinics, their locations and schedules, visit ECDOHs website.
A Northwell Health staff member holds the monkeypox vaccine, at Cherry Grove on Fire Island, New York, where monkey pox vaccines were administered on July 14, 2022.
James Carbone | Newsday | Getty Images
Health authorities in Ohio reported the death of an adult male who had monkeypox, the third fatality in the United States of someone who tested positive for that virus since the outbreak began in May.
The unidentified man had other health conditions, according to the state's health department, which announced his death late Thursday.
The federal Centers for Disease Control and Prevention in a health alert to physicians Thursday warned that people who have compromised immune systems due to HIV and other conditions face a higher risk of developing severe symptoms from the virus.
The U.S. had the largest monkeypox outbreak in the world, with more than 25,000 cases reported across all 50 states, Washington D.C., and Puerto Rico, according to CDC data.
The outbreak has started to slow as the two-dose Jynneos vaccine has become more widely available, and people have become more aware of what precautions to take to avoid infection.
Los Angeles health officials confirmed earlier this month that an individual with a severely compromised immune system died from monkeypox after being hospitalized.
Texas health officials reported in late August that an adult in the Houston area diagnosed with monkeypox had died. That person also had a severely compromised immune system. The cause of death in that case is still under investigation.
While monkeypox is rarely fatal it causes a rash resembling blisters that can be extremely painful.
The virus is primarily spreading among gay and bisexual men through close contact during sex. But anyone can catch the disease through close contact with someone who is infected or with contaminated materials.
Read CNBC's latest global health coverage:
In a study published earlier this month, the CDC found that 38% of 2,000 people diagnosed with monkeypox were living with HIV. And people with HIV were more likely to become hospitalized with monkeypox than other patients, according to the study.
The CDC, in its health alert this week, warned of severe monkeypox symptoms that include a persistent rash that turns into lesions resulting in the affected tissue dying. In some cases, treatment has required surgery and even amputation of the affected extremity, according to the agency.
Other severe symptoms include lesions that cover a significant portion of the body that are associated with secondary bacterial or fungal infections. Extremely painful lesions in sensitive areas such as the throat, urethra, rectum and vagina have also been reported.
Some lesions cause scarring that results in the narrowing of the urethra or anal canal, according to CDC. Facial scarring has also been reported.
In other instances, multiple organ systems have been affected resulting in neurological conditions such as encephalitis and cardiac conditions like myocarditis. Pink eye and ulcers on the cornea that threaten people's sight have also been reported.
ROCHESTER, N.Y. So you think youre getting kicked out of here because you tested positive for Monkey pox? I asked the woman.
Correct, thats what the note said, she answered.
Thursday morning a woman whose identity we are not revealing says she was kicked out of her temporary shelter for domestic violence because she tested positive for monkey pox. She said a Gates Police officer was at her door and she had 15 minutes to grab everything she and her two children owned and leave.
On her door was a notice from the hotel where the Monroe County Department of Human Services put her up. The notice gave the women until 11 a.m. Thursday to leave her shelter. The handwritten part of the notice said Due to your medical condition.
Hi yall. This is my room and my kids room, the woman said in a cell phone video she recorded Thursday morning.
She lived in a hotel room with her two children for about a week. She says the county department of human services put them here while she was on the Willow Domestic Violence Centers waiting list for a long term shelter.
How long do I have sir? she asked a hotel employee in the hallway.In the video, the hotel employee pushed her deadline to just after noon. When she got her car packed with everything she owned she met me at the property next door. She told me when she tested positive for monkey pox Thursday morning she alerted the county DHS staff at the hotel.
Brean: Sometime after that the notice was on your door.
Woman: As soon as I told the DHS workers downstairs they told me to go upstairs and go to your room and we will figure it out from there. Fifteen minutes after that there was a notice on my door to vacate immediately due to illness.I called the hotel and spoke to a manager. She told me the county removed the woman. The county closed her out the manager said on the phone.
County spokesman Gary Walker told me DHS would never end a placement for medical reasons. We dont do that, he said. Under no circumstances would we remove someone for medical reasons.
Im not revealing the hotel because its a temporary shelter for domestic violence victims, but I can tell you the notice on the door said the motel has ended your stay.
I called DHS and told them I was calling you, Channel 10 news because you cant put two kids out, you cant put us out like that. Its not right, she said. Once I mentioned channel 10 news they found me a new place.
When the woman was removed she was already under a 14 day quarantine order. The county says as soon as they were notified she was ordered to leave, they found her a new shelter. The woman told me she is in her new place and feels safe.
The county is still looking into why this woman was ordered to leave.
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Being vaccinated against the coronavirus can cut the risk of having long covid symptoms 12 weeks after the infection by 41 per cent
By Jason Arunn Murugesu
Being vaccinated against the coronavirus may reduce the risk of long covid among people who catch SARS-CoV-2
Dinendra Haria/SOPA Images/LightRocket via Getty Images
The risk of long covid may be considerably lower in people who catch the coronavirus after being vaccinated.
Daniel Ayoubkhani at the UKs Office for National Statistics (ONS) and his colleagues looked at a random sample of people, aged 19 to 69, who tested positive for the coronavirus between April 2020 and November 2021.
The sample included 3090 people who had received a second dose of either the Pfizer/BioNTech, Moderna or Oxford/AstraZeneca
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