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The situation with monkeypox (MPX) and vaccine availability is changing quickly. While it's especially important that international travellers are aware of the virus and how it's spread - there have also been locally acquired cases here in Australia.

It’s time for everyone to become familiar MPX and how to prevent it.

Below you can find a number of frequently asked questions about the virus, including information about the vaccine. (Last Updated 25 August 2022)

UPDATE: While many metropolitan clinics have exhausted their allocation of MPX vaccines, you can register your details below and we will notify you as we have more vaccines and appointments available.

Register Your Details

What is Monkeypox (MPX)?
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MPX is a viral infection caused by the monkeypox virus (MPXV). While MPXV was first identified several years ago, cases of MPX were rarely seen outside of Central and West Africa until recently. MPX is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks.

What are the symptoms?
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Initial symptoms can include fever, headache, muscle aches, low energy, and swollen lymph nodes (similar to COVID or the flu) before progressing to a skin rash or lesions. The rash usually begins within one to three days of the start of a fever. The rash or lesions can also be found on the face, arms, and legs as well as in the mouth and around the genitals/anus.

Because MPX rashes can resemble some STIs, it is important to contact your GP or local sexual health clinic and let them know about your symptoms when you make an appointment.

The incubation period (the time from infection to the onset of symptoms) of MPX is usually 7-14 days, but it can be as short as 1-2 days or as long as 21 days.

While symptoms are typically mild, for some people with moderate to serious cases MPX can be quite painful.

How is it transmitted?
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MPXV is transmitted through close physical contact with someone who has the virus - in particular through sexual or intimate contact.

While MPX is not classified as a sexually transmitted infection (STI), sexual contact with someone who has the virus poses a high risk of transmission.

Bodily fluids (such as fluid, pus or blood from skin lesions) and scabs are particularly infectious. Ulcers, lesions or sores in the mouth can also be infectious, meaning the virus can spread through saliva.

How is it treated?
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Most people with MPX have a mild self-limiting illness and recover within a few weeks without specific treatment.

There are some therapies available for the treatment of MPX, particularly for people at high-risk such as those who are immunosuppressed.

How many cases have there been?
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For the latest numbers of confirmed cases, you can head to:

Why are many cases of being detected among men who have sex with men?
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Currently, a large number of MPX cases are among gay, bisexual, and other men who have sex with men (MSM) and the current outbreak appears to be moving quickly amongst sexual networks.

One reason we're seeing more cases amongst MSM is due is their proactivity seek out sexual health advice. MPX rashes and lesions can resemble some STIs, such as herpes or syphilis. Consequently, MPX cases are being detected in sexual health clinics around the world.

However, the risk of MPX is not limited to gay, bisexual, and other men who have sex with men. Anyone who has close intimate or sexual contact with someone infectious is at risk.

Stigmatising people because of a disease is never okay. Anyone can get or pass on MPX regardless of their sexuality.

It's also really important you're aware of your HIV status. Experiencing MPX alongside untreated HIV or STIs may make your symptoms worse. Find out more about getting tested here.

Am I at greater risk if I’m HIV-positive?
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HIV positive people on effective antiretroviral treatment are at no greater risk than HIV-negative people.

However, if a person is severely immunocompromised and not on HIV antiviral medication, MPX can be of greater severity and duration.

There is very limited evidence on MPX in people living with HIV. The research that we do have is from countries where access to treatment is low and health experiences are poorer than in Australia. Should evidence emerge that people with suppressed immune systems are at greater risk of MPX, or ill-health from catching the virus, then updated information and advice will be made available.

What if I have recently returned from overseas?
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If you recently returned from overseas, in particular if you've being having casual sex while overseas or attended sex-on-premises venues, it's important that you monitor for symptoms. The MPX rash can appear at multiple sites across the body, so check around your mouth, genitals and anus for any new spots or lesions.

People who have recently returned from overseas and developed symptoms, particularly an unusual rash or swollen lymph nodes, should seek medical advice immediately.

You should stay at home and remain isolated until given further advice by your treating doctor. If you are presenting to a clinic or emergency department, call to let them know you are coming, wear a mask, inform the reception staff on arrival, and wait to be isolated until you can be seen by a clinician.

MPX can be transmitted to pets. If you are isolating and experiencing symptoms, it is recommended that you isolate away from any pets.

MPX can also be transmitted via clothing and other materials, so it is recommended that you wash all clothing items, towels and sex toys that you took overseas.

How is it prevented?
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To reduce your risk of acquiring MPX, there are some practices and behaviours you can adopt.

When it comes to sex:

  • Limit the number of sexual partners you have. MPX is moving through sexual networks. Limiting the number of partners you have reduces your risk of coming into contact with someone who has the virus.
  • Swap contact information with your hook-ups. If either of you develops symptoms, you can contact each other to go and get tested.
  • When having sex there are ways to limit skin-to-skin contact and contact with bodily fluids. So maybe don’t kiss or cuddle, avoid using spit for lube, use condoms, and be sure to wash your face, hands, and body parts after sex. Some may want to consider using condoms for receptive anal sex to reduce the risk of anal infection.
  • Create a 'sex bubble'. Similar to what some people did during COVID, you can have a select group of people where you are only having sex with each other. Each person agrees that they’d be happy to be part of the bubble and won’t have sex outside of that group. This limits the risk that you and your sex bubble come into contact with the virus.
  • If you have an open relationship, you might want to consider making it a closed relationship in the short term. The less people you play with, the less likely you are to come into contact with the virus.
  • Explore ways to get off by yourself or at a distance from others. Looking for ideas? Check out tips our community came up with for Sex & COVID or listen to WellWellWell's episode on Sex, Intimacy & COVID-19.

If you are planning to travel overseas:

  • Book an appointment to get your MPX vaccine. Ensure there are two weeks between getting the vaccine and engaging in behaviour that may expose you to the virus. It takes at least two weeks to offer the initial levels of protection against MPXV.
  • Follow public health alerts and advice from local health authorities of the countries you are visiting.
  • If visiting festivals or large events, keep alert of any event updates (before and after) from organisers.
  • Be aware and exercise caution if you plan to attend any events or venues that may include dark rooms, play spaces, or sex-on-premises.

Additional behaviours or practices that may limit the risk of MPX:

  • Check yourself for symptoms before heading out. If you are unwell or have a rash - stay home and seek a medical opinion.
  • Consider the type of event and venue you're going to. Close skin-to-skin contact in spaces where people may be wearing little-to-no clothes or spaces where sex is happening puts you at a greater risk of exposure.
  • Don’t share personal items, such as towels, toothbrushes, and sex toys.
  • Better to stay in your own bed than to sleep in someone else’s bed sheets.

These strategies may help reduce your risk of MPX, but the most effective tool for prevention is vaccination.

MONKEYPOX VACCINATION

As there is currently a very limited supply of the vaccine in Australia. In Victoria, vaccination access is limited to people who meet any of the following eligibility criteria:

  • Post-exposure prophylaxis for close contacts of monkeypox cases (within 4 days)
  • HIV-negative or HIV-positive sexually active gay, bisexual, or other men who have sex with men (MSM) (including cis and trans men)
    • who have had an STI in the last 12 months OR
    • intending to engage in sexual practices during overseas travel to Europe or North America before 31 October OR
    • who attend sex-on-premises venues (SOPVs) including saunas, adult cinemas/lounges, beats, or sex parties
  • Sexually active MSM who are homeless, have significant drug use, or psychiatric illness
  • Sex workers who engage in sex with MSM

Where can I get the vaccine?

Currently, vaccines are in limited supply across Australia. In the metropolitan Melbourne, the MPX vaccine is being offered through a small number of clinics, including Thorne Harbour Health.

While many clinics have exhausted their allocation of vaccines, you can register your details with us and we will notify you when we have more vaccines and appointments available.

Register Your Details

For individuals who meet the eligibility criteria for vaccination and reside in regional Victoria, email your closest regional Local Public Health Unit (LPHU).

Ovens Murray - phu@awh.org.au
Barwon South West - phu@barwonhealth.org.au
Gippsland/La Trobe - phu@lrh.com.au
Goulburn Valley - phu@gvhealth.org.au
Ballarat/Grampians - phu@bhs.org.au
Loddon Mallee - phu@bendigohealth.org.au

What vaccine is available for MPX?
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The vaccine that is currently available to prevent MPX is the JYNNEOS vaccine.

JYNNEOS is one of two vaccines approved for use for MPX in Australia.

The other vaccine, ACAM2000, is associated with rare but serious side effects and adverse events, especially in certain groups of people such as those who are severely immunosuppressed. Because of this, ACAM2000 is not recommended for mass vaccination.

How does the vaccine work?
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The JYNNEOS vaccine is a two-dose vaccine. There needs to be a minimum of 28 days or four weeks between doses.

At the moment, Australia is focusing on providing the first shot to as many at risk people as possible.

While supply is limited, second doses can be administered to people who meet the criteria for 'immunocompromised'. The JYNNEOS vaccine is safe to use in people who are immunocompromised.

Vaccination is highly effective, and a person will start to build protection in the days and weeks after their first dose, but it takes two weeks for someone to reach their highest level of protection following each dose. It should be noted that studies have been limited and there is a need to grow the evidence in this area.

Who is considered 'immunocompromised' with regard to the MPX vaccine?
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At least 28 days after receiving the first dose, second doses of the MPX vaccine can be administered to people who meet the criteria for 'immunocompromised'.

The Victorian criteria for ‘immunocompromise’ in relation to monkeypox vaccination eligibility has been informed by expert opinion and is subject to updates by the Australian Technical Advisory Group on Immunisation (ATAGI). The criteria include:

  • Primary immunodeficiency or acquired immunodeficiency: HIV/AIDS with CD4 count <200, or uncontrolled viraemia
  • Haematologic neoplasms: leukaemias, lymphomas, myelodysplastic syndromes, multiple myeloma and other plasma cell disorders, post-transplant: solid organ (on immunosuppressive therapy), haematopoietic stem cell transplant (within 24 months), primary immunodeficiency,
  • Receipt in the last 3 months any of:
    • Chemotherapy or whole-body radiotherapy
    • High-dose corticosteroids (≥ 20 mg of prednisone per day, or equivalent) for at least 14 days in 1 month, or pulse corticosteroid therapy
    • Biological agents and other treatments that deplete or inhibit B- or T-cell function (anti-CD20 antibodies, BTK inhibitors, JAK inhibitors, sphingosine 1-phosphate receptor modulators, anti-CD52 antibodies, anti-complement antibodies, anti-thymocyte globulin)
    • Selected conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) including mycophenolate, methotrexate (more than 0.4 mg/kg/week), leflunomide, azathioprine (at least 3 mg/kg/day), 6-mercaptopurine (at least 1.5 mg/kg/day), alkylating agents (eg, cyclophosphamide, chlorambucil), and systemic calcineurin inhibitors (eg, cyclosporin, tacrolimus)

What are the common side effects of the vaccine?
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Side effects are common but usually mild. Most people have redness, swelling and pain in the spot where they received the injection. Tiredness, headache and muscle pain can also occur after vaccination.

Do I need a Medicare card to receive the vaccine?
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No. While some vaccination sites may ask you to bring a Medicare card along to your appointment, MPX vaccines are available at no charge to everyone regardless of their Medicare status.

I have been exposed to Monkeypox - am I eligible for the vaccine?
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Anyone categorised by public health authorities as a high risk MPX contact should get the vaccine. Speak to your GP or healthcare professional about vaccine access if you are a close contact.

I have symptoms of Monkeypox - am I eligible for the vaccine?
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If you have symptoms of MPX it is important to speak to a healthcare provider first before accessing a vaccine appointment.

Are more vaccines on their way to Australia?
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Yes. The federal and state governments are working to secure more supplies of the vaccine. As more vaccines become available, more people can get vaccinated against MPX.

For more information about Monkeypox, head to https://www.health.vic.gov.au/infectious-diseases/monkeypox

We recently spoke with Dr Vincent Cornelisse to unpack what we know about the current MPX outbreak - including vaccines and other ways to limit your risk of acquiring MPX.

Watch this space. As more cases arise, we're learning more and more about MPXV. We will be releasing updates to the community as the situation around MPXV continues to evolve.

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