How effective is Monkeypox Vax?no one can confirm

In a community of gay men in America worried about contracting monkeypox, a message suggests it’s all temporary: Months of sexual prudence plus vaccinations will usher in a carefree autumn.

“For your own safety and for keeping you safe from the horrors of this disease,” sex columnist Dan Savage suggested on Twitter over the weekend, “you may Want to dial it back a couple of weeks while we roll the vaccine out.” AIDS Magazine POZ advises readers to “put off the slutty summer” and wait for the fall, when ” We want to have enough Jynneos vaccine for everyone who wants it.”

However, no one knows how well the Jynneos vaccine works as an infection-free card.

A digital various media organization cites this without question – “85% effective” or “at least 85% effective” – ​​based entirely on a 1980s campaign in Africa This small study has significant limitations. One data expert called its findings “pretty weak”. Other studies have only been done in animals.

However, “I’ve heard from many people in the community that they expect little or no risk of infection within 2 weeks of the first shot,” NYC data scientist and LGBT Health advocate Michael Donnelly, MS, said in an interview with MedPage Today. “Or they think they won’t have any symptoms if exposed before the injection.”

Lack of accurate information about vaccines is “a big problem,” Jay Varma, MD ( Jay Varma, director of the Cornell Center for Pandemic Prevention and Response in New York, said in an interview. “Public health officials must strive to communicate this uncertainty to those who are vaccinated.”

Vaccine hypothesis based on Small, ‘Weak’ 1988 study

As of July 29, the CDC reported that the current outbreak has infected 5,189 people in the U.S. in nearly every state ( excluding Montana), Wyoming and Vermont) plus Puerto Rico. New York has been the most affected so far with 1,345 cases, followed by California with 799, Illinois with 419, Florida with 373, and Texas and Georgia with 351 each. Washington, D.C. has a particularly high per capita rate, with 218 cases in a city of 702,000 people.

Men who have sex with men are considered the most vulnerable – they make up 98% of 528 cases worldwide in a recent analysis, many gay men have been on social media or Talk to reporters describing severe pain, horrific lesions and barriers to care.

Hundreds of thousands of Jynneos smallpox/monkeypox vaccines are now available in the U.S., and the CDC recommends vaccination for those who have been exposed to monkeypox or are at higher risk.

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

As the CDC notes, “there are currently no data on the effectiveness of these vaccines in the current outbreak.” As for previous outbreaks , only one study—a retrospective analysis published in 1988—examined whether the smallpox vaccine protects against monkeypox.

In that study, researchers followed 209 household contacts of people who contracted monkeypox in Zaire in the early 1980s. Those scarred by previous smallpox vaccinations (70 percent) were 85 percent less likely to be infected. The vaccine appears to be 89 percent effective in protecting contacts outside the home from infection.

Statistical analysis was limited because it had no confidence intervals or values ​​for age, Ira Longini, Ph.D., a biostatistician at the University of Florida told Medicine Today page. Also, he said, the data are purely based on signs of vaccination. The study “is the only evidence we have [on the vaccine’s effectiveness], and it’s very weak. In principle it should work, but we don’t know.”

Jynneos and ACAM2000 are a new generation of vaccines, For example Dryvax used in the 1980s. “These vaccines have not been directly tested against smallpox or monkeypox,” Dr. Richard Kennedy, co-director of the Mayo Vaccine Research Group in Rochester, Minnesota, told MedPage Today. “They generated an immune response very close to a first- or second-generation vaccine: a little weaker, but not much.”

Kennedy added that the vaccines were also tested against monkeypox. Test five to ten different animal studies. “The data are also clear and consistent with very good protection from disease, with animals showing little or no symptoms of disease after challenge,” Kennedy said. “The animal data were strong enough that the FDA approved Jynneos for prophylactic monkeys. Pox permission.”

Unique outbreaks may weaken vaccine effectiveness

To complicate matters, the new outbreak is very different from previous ones. This time, the virus appears to be spreading primarily through sexual contact rather than other forms of contact, with the vast majority of cases occurring among men who have sex with men. (The medical community is now debating whether monkeypox is a sexually transmitted disease [STD].) Previous outbreaks in Africa appear to have spread in households through a variety of routes.

“Vaccines are assessed on the assumption that most or all exposure is from skin-to-skin contact,” Varma told MedPage Today . “The head of the penis and the inside of the anus may have features that make them more susceptible to infection, such as lower viral doses required, fewer antibodies or other components of the immune system, or concurrent STDs that increase risk. This may be the level of protection that may is the same, but we should not assume it is the same without evaluating it.”

Furthermore, he said, “It is theoretically possible for the monkeypox virus to mutate which makes It is more contagious or virulent to humans. The scientific consensus is that, given the type of virus, this does not happen as fast as COVID. COVID is an RNA virus whereas 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,” he said. “This is different from COVID-19, where every few months there is a massive immune evasion of a new strain. Poxviruses have a lot of cross-protection — an immune response to one poxvirus can identify most of the others. Pox virus.”

Fine-tuned monkeypox prevention message

Despite evidence of weakness, the 85% validity figure is everywhere – sometimes eligible, sometimes not. Even Yale and Harvard have issued health alerts, citing the 85% figure without noticing its uncertainty.

Meanwhile, monkeypox prevention information for gay and bisexual men continues to vary. Vaccinations and other tactics have been touted as officials worry about stigmatizing gay men.

Last week, the head of the World Health Organization recommended “reducing the number of sexual partners, reconsidering with new partners, and exchanging contact details with any new partners so that we can do this if needed. Follow up.”

If someone may be infected, the CDC offers advice on having sex: stay 6 feet apart when masturbating with each other and avoid kissing. MagazinePOZ recommends using condoms, dressing more at circuit parties and bars, and creating sex ‘pods’ similar to groups that only socialize with friends and relatives amid COVID- 19 Communicating with each other during the pandemic.

Recommendations about condoms can be particularly difficult for men who have sex with men. Many gay men prefer to take preventive medicines like emtricitabine/tenofovir (Descovy, Truvada) to reduce the risk of HIV transmission, or if they are HIV positive, medicines to lower their viral load to undetectable levels.

“The message of prevention should be that vaccination will be an important part of controlling this outbreak, and we need everyone to get vaccinated ASAP,” said Donnelly, a data scientist and LGBT health advocate. “But even if you’re vaccinated, you’re still at risk, and unprotected anal sex is probably the highest risk.”

“Even after vaccination,” he added, “you May want to consider reducing the number of sexual partners and use condoms or seek other safer sex practices.”

• Randy Dotinga is from San Diego A freelance medical and science journalist.