How effective is Monkeypox Vax? No one knows

Across America’s gay male community, who are worried about contracting monkeypox, there is one message that suggests this is all temporary.

“For your own safety and the horrors of this disease” sex columnist Dan Savage suggestions on twitter Last weekend, “While we roll out a vaccine, you may want to consider dialing back a few weeks.” POS Recommendation Readers are hoping to ‘postpone the lewd summer’, wait for the fall, and ‘provide enough Jynneos vaccines for everyone who wants it’.

But how well the Jynneos vaccine works as an escape card from infection is anyone’s guess.

One number that has undoubtedly been cited by various media organizations –“85% effective” Also “at least 85% effective— Based entirely on a small study done in Africa in the 1980s, it has significant limitations. One of his data experts called the results “pretty weak.” Other studies have been conducted only in animals.

Still, “I’ve heard from many people in the community that they expect there to be little risk of being infected two weeks after the first injection,” he said. Michael Donnelly As MSc, a data scientist and LGBT health advocate in New York City, said in an interview: MedPage Today“Or they think that if they were exposed before they were vaccinated, they would not develop any symptoms.”

Lack of accurate information about vaccines is a ‘big problem’. Jay Varma, M.D.The director of the Cornell Center for Pandemic Prevention and Response in New York said in an interview. ”

Vaccine Assumptions Based on a Small, “Weak” 1988 Study

As of July 29, the CDC report The current outbreak has caused 5,189 infections in the United States, hitting nearly every state (all but Montana, Wyoming and Vermont) and Puerto Rico. New York is the most affected with 1,345, followed by California 799 in Illinois, 419 in Florida, 373 in Florida, and 351 each in Texas and Georgia. Washington, DC, with 218 cases in a city of 702,000, has an especially high per capita infection rate.

Men who have sex with men are considered the most vulnerable. Recent analysis –and many gay men left on social media Also spoke to a reporter Describe severe pain, frightening lesions, and barriers to care.

Hundreds of thousands of Jynneos smallpox/monkeypox vaccines Now available in the USand CDC recommend vaccination For people who have had monkeypox or are at high risk.

Health officials prefer the FDA-approved Jynneos vaccine, manufactured by the Danish company Bavarian Nordic, to prevent both smallpox and monkeypox. An alternative vaccine, ACAM2000, is complicated to administer, produces nasty and infectious pustules, and can cause side effects in some people, such as those with weakened immune systems. vox.

As noted by the CDC, “There is still no data on the efficacy of these vaccines in the current outbreak.” Regarding previous outbreaks, only one study – A retrospective analysis published in 1988 — We investigated whether the smallpox vaccine could prevent monkeypox.

In that study, researchers followed 209 household contacts who were infected with monkeypox in Zaire in the early 1980s. A person with scars from a previous smallpox vaccination (70%) was 85% less likely to be infected, and the vaccine was 89% more effective for him in protecting contacts outside the home from infection. I thought there was.

Statistical analysis is limited by the lack of confidence intervals and adjustment for factors such as age. Dr. Ira LonginiA biostatistician at the University of Florida said: Today’s Medpage. He also said the data are based purely on physical signs of vaccination. [in regard to vaccine effectiveness], which is pretty weak. In principle it should work, but I don’t know. “

Jinneos When ACAM2000 Newer generation vaccines such as dryvax used in the 1980s. “These vaccines have not been directly tested against smallpox or monkeypox,” he said. Dr. Richard KennedyCo-Director, Mayo Vaccine Research Group, Rochester, Minnesota, in an interview MedPage Today“The immune response they generate is very similar to first or second generation vaccines: a little weaker, but not by much.”

Kennedy added that the vaccine has also been tested against monkeypox in five to 10 different animal studies. “These data are unequivocal, animals show little to no symptoms of disease after challenge, consistent with very good protection against disease,” Kennedy said. and the FDA has cleared Jynneos for monkeypox prophylaxis.”

Unique outbreaks could weaken vaccine effectiveness

To make things even more complicated, the current trend is quite different from the past.This time, the virus appears to be transmitted primarily through sexual contact rather than other types of contact, with the overwhelming majority of cases found among men who have sex with men. Monkeypox sexually transmitted disease [STD].) Previous outbreaks in Africa appear to have spread within households. various routes.

“Vaccines were evaluated on the assumption that most or all exposure was through skin-to-skin contact,” Varma said. MedPage Today“The head of the penis and the interior of the anus may have characteristics that make it more susceptible to infection, such as requiring lower doses of virus, lower antibodies and other components of the immune system, and concomitant STDs.” may have the same protection level, but should not be assumed to be the same without evaluation.”

“It is theoretically possible that the monkeypox virus could mutate to become more contagious or pathogenic to humans. COVID is an RNA virus and monkeypox is a DNA virus.”

Kennedy agreed. “The current outbreak is caused by a strain that has some genetic differences but is still very close to the strain that caused monkeypox in the 1980s.” Unlike COVID-19, where new strains emerge with poxviruses, there are many cross-protections: an immune response to one poxvirus can recognize most other poxviruses.”

Tweaks to monkeypox prevention messages

Despite the weak evidence, the figure of 85% efficacy is everywhere.flat Yale University When Harvard University Published a health alert citing an 85% figure without mentioning uncertainty.

Meanwhile, monkeypox prevention messages aimed at gay and bisexual men continue to vary. Vaccination is highly touted, along with other strategies, as authorities are concerned about stigmatizing gay men.

Last week, the head of the World Health Organization was suggested “Reduce the number of sexual partners, reconsider having sex with a new partner, and exchange contact information with the new partner so that follow-up can be done if necessary.”

CDC gave advice Regarding sex when someone may be infected: Stay 6 feet apart and avoid kissing during mutual masturbation.and magazine POS It suggests using condoms, wearing more clothes at circuit parties and bars, and creating sex “pods” similar to groups of friends and relatives that only interacted during the COVID-19 pandemic.

Suggestions about condoms can be particularly difficult for men who have sex with men. Many homosexuals choose to reduce their risk of HIV infection by taking prophylactic medications such as emtricitabine/tenofovir (Descovy, Truvada) or, if HIV-positive, medication to lower the viral load to undetectable levels. I like

Donnelly, a data scientist and LGBT health advocate, said, “The message of prevention is that vaccination is an essential component of controlling this outbreak and that everyone should be vaccinated as soon as possible.” “But even if you’ve been vaccinated, the risks are still there, and unprotected anal sex may be the most risky.”

“Even after vaccination, we recommend that you consider reducing the number of sex partners, using condoms, or pursuing other safer sex approaches.”