Wisconsin DHS Health Alert #48: Expanded Monkeypox Vaccine Eligibility Criteria
This message is being sent in advance to health care providers, local and tribal health departments, and other locations administering the monkeypox vaccine to inform them of upcoming changes to vaccine eligibility criteria. The Wisconsin Department of Health Services (DHS) plans to publicly announce expanded eligibility criteria on September 6, 2022.
Bureau of Communicable Diseases
September 1, 2022
Key Points
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DHS will expand the eligibility criteria for JYNNEOS, the preferred vaccine to prevent monkeypox.
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The JYNNEOS vaccine is available by appointment at designated health care locations and local health and tribal departments throughout the state for eligible people.
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DHS recommends that all vaccinators administer JYNNEOS intradermally, in accordance with the U.S Food and Drug Administration’s announcement. Intradermal vaccination is safe and yields a comparable immune response to that from a standard subcutaneous injection. There are some instances where subcutaneous vaccination will still be necessary.
Background
DHS is issuing this Health Alert Network (HAN) Health Advisory to notify clinicians and public health authorities of expanded eligibility criteria for JYNNEOS, the preferred vaccine to prevent monkeypox. Beginning September 6, 2022, the JYNNEOS vaccine will be available to Wisconsinites who meet at least one of the following criteria:
- Known contacts who are identified by public health via case investigation, contact tracing, and risk exposure assessments (PEP).
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Presumed contacts who may meet the following criteria (PEP++):
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People who know that a sexual partner in the past 14 days was diagnosed with monkeypox.
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People who attended an event or venue where there was known monkeypox exposure.
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Gay men, bisexual men, trans men and women, any men who have sex with men, and gender non-conforming/non-binary individuals, who have had multiple sexual partners in the last 14 days.
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People considered to have elevated risk of exposure to monkeypox in the future (PrEP):
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Gay men, bisexual men, trans men and women, any men who have sex with men, and gender non-conforming/non-binary individuals who expect to have multiple or anonymous sex partners. This may include people living with HIV and people who take HIV PrEP because of increased risk of sexually-transmitted infections.
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Clinical laboratory personnel who perform testing to diagnose orthopoxviruses, including those who use polymerase chain reaction (PCR) assays for diagnosis of orthopoxviruses, including Monkeypox virus.
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Research laboratory workers who directly handle cultures or animals contaminated or infected with orthopoxviruses that infect humans, including Monkeypox virus, replication-competent Vaccinia virus, or recombinant Vaccinia viruses derived from replication-competent Vaccinia virus strains.
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Certain health care providers working in sexual health clinics or other specialty settings directly caring for patients with sexually transmitted infections.
If vaccine supply becomes constrained, vaccinators should prioritize individuals who meet the criteria for PEP, followed by PEP++, and then PrEP.
JYNNEOS vaccine is available by appointment at designated health care locations throughout Wisconsin for eligible people. If someone who is eligible is unable to make an appointment at a location offering JYNNEOS, please encourage them to contact their local or tribal health department for assistance connecting with a vaccinator.
As of September 1, 2022, DHS has ordered all vaccines allowable by the federal government. In total, 3,854 vials of JYNNEOS have been made available to Wisconsin. An additional 1,760 vials have been allocated to Wisconsin but are not yet available for ordering from the federal government. Approximately 40% of the vaccine vials that Wisconsin has received have been administered.
On August 9, 2022, the FDA issued an emergency use authorization (EUA) for the JYNNEOS vaccine. The EUA allows vaccinators to inject one-fifth the volume of JYNNEOS intradermally for individuals 18 years and older. Individuals under the age of 18 should receive the vaccine by subcutaneous injection.
This new approach allows health care providers to use an existing one-dose vial of the vaccine to administer a total of up to five vaccine doses. The intradermal method of injecting the vaccine is safe and yields a comparable immune response to that from a standard subcutaneous injection. DHS strongly encourages intradermal vaccination. However, there are some instances where subcutaneous vaccination is still necessary (e.g., when a patient is under the age of 18).
A person is considered fully vaccinated when they have received two doses of JYNNEOS at least 28 days apart, whether the vaccine is administered subcutaneously or intradermally. A person aged 18 years and older who received their first dose of JYNNEOS subcutaneously may receive their second dose intradermally to complete their vaccine series.
Resources
Sincerely,
Ryan Westergaard, MD, PhD, MPH
Chief Medical Officer and State Epidemiologist for Communicable Diseases
Wisconsin Department of Health Services
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