Who should get the monkeypox vaccine now, according to health officials

Any man who has sex with other men via hookup apps, at sex parties or in other anonymous settings should get the monkeypox vaccine, according to public health recommendations issued as the outbreak continues to spread almost exclusively in that population.

Although any person can get monkeypox, at least 98% or 99% of those who have contracted the virus in the current outbreak — focused in the United States and Europe — are men who have sex with men, said epidemiologist Dr. Jay Varma, who has held top public health posts at the Centers for Disease Control and Prevention and as New York City’s top COVID-19 adviser.

“Particularly in areas of the country — like New York City — where you’re seeing a lot more people increasingly with this infection, I feel very strongly that that is the right target group for this vaccination, and it’s very important to get this message out,” Varma told Newsday in an interview.

As of Wednesday,  119 people in the city had tested positive for orthopoxvirus, which is a likelyindication of monkeypox, according to the city health department’s website. On July 1, Suffolk’s health department announced the county’s first case, the department said in a news release.

"Monkeypox can spread from person to person most often through direct and prolonged contact with the infectious rash, scabs, body fluids, or respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling or sex," the news release said. No one has died in the current outbreak, but studies in Africa show that the disease killed up to 11% of those infected, the CDC said.

An email to the Suffolk health department was returned by Nicole Russo, a spokeswoman for County Executive Steve Bellone. She declined to provide any demographic detailsabout the county’s case, citing privacy. Nassau  has no cases, according to Christopher Boyle, a spokesman for County Executive Bruce Blakeman.  Boyle said the county got 400 vaccine vials Wednesday, but he wasn't specific about the exact locations where shots would be available.

Nationwide, there were 605 cases as of Wednesday, according to the CDC, and more than 6,000 total in the current outbreak, 80% of whichin Europe, according to the World Health Organization.

The vaccine also provides protection after potential exposure, as is recommended in what’s called post-exposure prophylaxis. It should be given within four days of exposure to prevent the onset of monkeypox; if given between 4 and 14 days of exposure, the vaccine may reduce symptoms but not prevent the disease, the CDC said.

The city health department, which schedules appointmentsvia nyc.gov/health/monkeypox, says those who are eligible are "all gay, bisexual, and other men who have sex with men (cisgender or transgender) ages 18 and older who have had multiple or anonymous sex partners in the last 14 days." 

There's no residency requirement for the vaccine, according todepartment spokesman Patrick Gallahue.

"Men who have sex or other intimate contact with men they met through dating apps or social media platforms, or at clubs, raves, sex parties, saunas, or other large gatherings may be at higher risk of having been recently exposed," the department said.

For now, those who aren’t currently recommended to get the vaccine: women, children,  and people in monogamous relationships — gay, straight or bisexual, Varma said. The eligibility exception, he said, is someone who is a known contact with someone at risk — such as being in the household.

“There is a possibility that sometime, whether it’s sometime this year, or sometime in the future, we may need to encourage more people to get the vaccine,” he said. 

On Wednesday, the CDC announced in a news release that the chain Labcorp would begin testing for monkeypox — with capacity for up to 10,000 tests per week, doubling the current capacity through the CDC.

Varma, now a Weill Cornell Medicine professor of population health sciences, says thevaccine's main side effects are pain and discomfort in the arm, achiness, a feeling of fever and chills, and in rare cases, heart inflammation.

He said it’s safer to have sex with a known partner or, if you’re having sex with more than one person, to choose those who were known to be uninfected. 

“We have to always be careful when we talk about this, because there’s such a long history of stigmatizing any same-sex activity,” he said, “and so we want to be cautious about emphasizing that what we want to do is to recommend that people be careful and thoughtful about participating in activities that are higher-risk.”

By Matthew Chayes

matthew.chayes@newsday.comchayesmatthew

Matthew Chayes, a Newsday reporter since 2007, covers New York City.