US may expand monkeypox vaccine eligibility to men with HIV

US may expand monkeypox vaccine eligibility to men with HIV

NEW YORK — U.S. officials are considering broadening recommendations for who gets vaccinated against monkeypox, possibly to include many men with HIV or those recently diagnosed with other sexually transmitted diseases.

Driving the discussion is a study released Thursday showing that a higher-than-expected share of monkeypox infections are in people with other sexually transmitted infections.

Dr. John T. Brooks, chief medical officer for the Centers for Disease Control and Prevention’s monkeypox outbreak response, said the report represents a “call to action.”

Brooks told The Associated Press on Thursday that he expected vaccine recommendations to expand and that “the White House, together with CDC, are working on a plan for what that will look like.”

Currently, the CDC recommends the vaccine to people who are a close contact of someone who has monkeypox; people who know a sexual partner was diagnosed in the past two weeks; and gay or bisexual men who had multiple sexual partners in the last two weeks in an area with known virus spread.

Shots should also be recommended to health workers who are at highest risk.

The majority of cases of monkeypox are found in people who have had sex in close proximity with infected persons during sex. The CDC has now suggested that HIV/STDs and infections of people living with HIV may pose a greater problem than previously thought.

The report looked at about 2,000 monkeypox cases from four states and four cities from mid-May to late July.

It found 38% of those with monkeypox infections had been diagnosed with HIV, far higher than their share of the population among men who have sex with men.

The study also found that 41% of monkeypox patients had been diagnosed with an STD in the preceding year. And about 10% of those patients had been diagnosed with three or more different STDs in the prior year.

There were racial differences. More than 60% of Black Americans with monkeypox had HIV, compared with 41% of Hispanic people, 28% of whites and 22% of Asians.

Jason Farley is an infectious disease specialist at Johns Hopkins School of Nursing. He said that men of color should not have had sex with other men and should therefore be first in line to receive monkeypox vaccination doses. He said that anyone with HIV, or who has recently been diagnosed with STDs, should be the priority within those racial/ethnic groups.

The study has several limitations, including that the data may not be nationally representative, the authors said.

Brooks said the findings could lead to vaccines being recommended for people with recent STD infections, people with HIV, people taking pre-exposure prophylaxis (PrEP) medications to prevent HIV infection and, possibly, prostitutes.

Discussions of expanding eligibility will have to take into account supply of the two-dose vaccine. Health officials also say that any significant expansion in monkeypox vaccine recommendations could be reviewed by the CDC’s external vaccine advisors.

Another letter was sent by the CDC to states and local health departments on Thursday stating that federal funds can now also be used for monkeypox prevention and HIV treatment STD Prevention . Cases in the U.S. seem to be declining, officials say.


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