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Signs point to where to line up to receive the mpox vaccine (previously known as monkeypox) last year at DTLA Proud, an LGBTQ+ festival.
(Jackie Fortiér
/
LAist)
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Festival season could trigger another surge of mpox cases, health officials warn.
A recent outbreak of 21 mpox cases in Chicago prompted experts at the Centers for Disease Control and Prevention to issue a nationwide health alert. They are concerned that mpox cases could rise during the summer, especially as transgender people and gay and bisexual men (who are most at risk) travel to Pride festivals and other major LGBTQ+ events.
But unlike summer 2022, when vaccines, testing and treatment were extremely difficult to obtain, L.A. County health officials say there is ample supply. The two-dose vaccine is still free. The CDC estimated in a study that a single dose of the vaccine is 75% effective at preventing mpox, while two doses are about 86% effective.
Mpox, formerly known as monkeypox, is caused by a virus in the same family as smallpox, though it’s not as transmissible or fatal. Typically, patients have a fever, muscle aches, and then a rash on their face, mouth, hands, and possibly genitals and rectum that can last for several weeks. The rash can be very painful.
“It starts out generally as like a flat lesion, and then over the course of a few days it will develop into more of a small bump, then a pustule, and then more like a crater with a crust over it,” said Sonali Kulkarni, Medical Director of HIV and STD programs at Public Health.
“Essentially any kind of abnormal skin rash could be consistent with mpox. Sometimes if folks have it in their anal area they may not be able to see it, but it's a painful lesion. Usually people do seek care if they have lesions there because it's very painful,” she said.
Mpox is spread via human-to-human contact, such as touching a lesion by rubbing against someone while dancing or having sex, as well as exchanging saliva or other bodily fluids. People can also become infected by touching objects or surfaces, such as sex toys or sheets, shared with someone with the illness, though this is a less common form of transmission.
Who is most at risk?
In May 2022, a global mpox outbreak rapidly spread through person-to-person contact and disproportionately affected transgender people and men who have sex with men.
What happened with the outbreak that started last year?
The U.S. outbreak peaked in August at about 460 cases per day. Since then, cases have receded, though two mpox cases were reported in L.A. County in April. Global case counts have continued to decline since the early-August peak. In total, 2,456 people have tested positive in L.A. County and two people have died. As of May 10, a total of 30,395 cases have been reported in the U.S. with 42 fatalities.
The free vaccine, known as Jynneos, consists of two doses given a month apart.
The shots are given in the arm.
The vaccine is not a live virus, you cannot contract mpox from the vaccine.
You can get other vaccines at the same time, such as the bivalent COVID shot. Just get them in different arms.
People will have peak immunity two weeks after their second dose, according to the CDC. It’s unknown how long that immunity will last. Booster doses are not recommended.
“The vaccine is not a hundred percent effective against mpox, but the clinical evidence shows that people who've been vaccinated get a milder case. Severe cases can be painful and it can affect your entire body,” Kulkarni said.
Who should get the mpox vaccine?
These high-risk people should get vaccinated, according to the CDC:
People who had known or suspected exposure to someone with mpox.
People who had a sex partner in the past 2 weeks who was diagnosed with mpox.
Gay, bisexual, and other men who have sex with men, and transgender or nonbinary people (including adolescents who fall into any of these categories) who, in the past 6 months, have had:
A new diagnosis of one or more sexually transmitted diseases (e.g., chlamydia, gonorrhea, syphilis).
More than one sex partner.
People who have had any of the following in the past 6 months
Sex at a commercial sex venue.
Sex in association with a large public event in a geographic area where mpox transmission is occurring.
Sex in exchange for money or other items.
People who are sex partners of people with the above risks.
People who anticipate experiencing any of the above scenarios.
People with HIV infection or other causes of immunosuppression who have had recent or anticipate potential mpox exposure.
People who work in settings where they may be exposed to mpox.
I got one mpox shot, but not the second. Am I protected?
Somewhat, but the full two doses means much more protection.
“It’s never too late to get the second dose,” said Kulkarni. She says even getting vaccinated at an event or festival will provide some protection.
Kit Williamson said the intradermal Jynneos shot "didn't hurt at all."
(Jackie Fortiér
/
LAist)
Where can I get the mpox vaccine?
You can find a vaccination site near you at myturn.ca.gov. Vaccines are free.
Mpox vaccines will also be available at these SoCal Pride events:
Weho Pride: 6/2-6/4
LA Pride: 6/11
Trans Pride: 6/16/-6/17
Juneteenth: 6/18
Compton Pride: 6/24
Long Beach Pride: 8/5
Indigenous Pride: 10/8
DTLA Pride (date to be determined)
Palm Springs Pride: 11/4-11/5
Will I need to answer a bunch of sexual health questions to get an mpox vaccine?
No. “We no longer require any collection of risk data for folks to explain the reason why they need the vaccine,” Kulkarni said. “If they simply ask for it, they'll receive it.”
I don’t remember how many mpox shots I got. How can I find out?
Contact the health provider where you received the shot and ask. It may also be on your health portal. If you got it through an L.A. County site or mobile vaccine clinic you should have received text messages reminding you to get the second vaccine a month later. County health officials say they sent out another text blast to people who still need their second doses in May.
I already received both Jynneos doses last year. Do I need a booster?
Nope! You are up to date.
I’m fully vaccinated and headed to Pride. How can I protect myself from mpox?
“I tell patients to be safe and smart at events, but not to avoid them,” said Sushant Banderpalle, Regional Medical Director at St. John’s Community Health in L.A. “We have Pride events for a reason, we're celebrating our freedom. I’m vaccinated against mpox. At the same time, we want to be safe and be smart about it.”
Since mpox is usually spread through direct skin-to-skin contact, Banderpalle said it’s best to avoid:
Close contact with people who have a rash
Touching the rash or scabs of someone with mpox
Having sex with someone with mpox or who has a rash that looks like mpox
Sharing clothing or bedding with someone who has mpox
According to the CDC, men who have sex with men make up most of the reported cases in the current mpox outbreak. But anyone who's been in close contact with someone who has mpox is at risk.
I was exposed or may have mpox. What should I do?
Don’t panic. Mpox is rarely fatal and treatment is available. Isolate yourself and call your doctor’s office.
Mpox tests need to be processed at a qualified laboratory facility, so you need to get tested by a health care professional. They will swab your rash and check your body for other lesions. There is currently no home test for mpox. If you get diagnosed with mpox, talk to your doctor about pain management and possible treatment.
Don’t put off testing hoping it will go away. Mpox lesions can rapidly increase in just a few hours.
“We've had cases where patients were avoiding urinating because the lesions were in their urethra, and they just didn't want to feel the pain and they would then end up not even drinking water so they don't produce urine. Then they were getting dehydrated, going and getting IV fluids in the emergency room,” Banderpalle said.
“The disease can progress where you may end up going to the hospital. It’s worth it to get vaccinated because even if you get mpox, it won’t be as severe,” he said.
What is the treatment for mpox?
Tecovirimat, an antiviral medication branded as TPOXX, has received special clearance from the FDA to treat monkeypox in certain circumstances. It is a prescription medication. Most people take it in pill form at home for multiple days, but it can be given intravenously if you are hospitalized with a severe mpox case.
“Initially, before we had access to TPOXX, we were giving a lot of medication that was mainly managing their symptoms. Not the actual disease,” Banderpalle said. “With TPOXX we are able to actually target the disease process in the body. A lot of the patients had a very good response to the treatment,” he said.
What’s the turnaround time on the mpox test?
It depends on the lab that is doing the testing, but it can take 2-7 days.
Banderpelle said he’s treated multiple people with mpox and doesn’t wait for a test result to start treatment.
“Generally what we do is something called presumptive diagnosis and treatment,” he said. “If we do highly suspect mpox, we're able to write the prescription [for the antiviral TPOXX] the day of, and we're actually delivering it to our patients by the next day so they're able to isolate and take their medication safely.”
Does the mpox virus have variants?
All viruses change and evolve over time. However, the mpox virus is a DNA virus which mutates slower than coronaviruses, which are RNA viruses (the virus that causes COVID-19 is a coronavirus). There are two known families or “clades” of mpox virus. The clade identified in Europe and in the United States is clade two, which tends to cause less severe disease and is less fatal than clade one, according to the World Health Organization.
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