Expert: Action should be taken now to prevent wider outbreak

Israel’s initial monkeypox vaccine rollout to focus on HIV-positive and at-risk men

Rollout to start within days; priority for men born after 1980 who have HIV, are on HIV pre-exposure meds or have contracted an STD this year

Illustrative -- People wait in line to receive the monkeypox vaccine before the opening of a new mass vaccination site at the Bushwick Education Campus in Brooklyn on July 17, 2022, in New York City (Kena Betancur / AFP)
Illustrative -- People wait in line to receive the monkeypox vaccine before the opening of a new mass vaccination site at the Bushwick Education Campus in Brooklyn on July 17, 2022, in New York City (Kena Betancur / AFP)

An initial shipment of several thousand doses of monkeypox vaccine is slated to arrive in Israel this week, with shots expected to be rolled out by the weekend to those considered most as risk of contracting the virus.

According to a letter from the Health Ministry to the four health maintenance organizations and the heads of Israeli hospitals, highest priority for the vaccine will be given to men born after 1980 who are HIV positive or are taking pre-exposure prophylaxis medication to reduce their chance of contracting HIV. (Israel vaccinated the general population against smallpox until 1980 — although the military continued for a number of years — and that vaccine can provide protection against monkeypox.)

In addition, those who have tested positive for syphilis, chlamydia or gonorrhea since January 1 of this year will be considered a high priority to receive the vaccine.

The ministry also noted that those who have been exposed to the virus but don’t fit in one of the relevant categories will be considered for the vaccine in certain cases.

The vaccine is only approved for those over age 18, although the ministry said that in certain cases it may weigh its use in children and teenagers following exposure, and that early data shows the vaccine is effective in those cases.

Further shipments of the vaccine, totaling 10,000 doses so far, are expected to arrive in Israel in the coming weeks.

A patient, who has recovered from monkeypox, shows a photo of a rash on his skin during an interview in New York on July 19, 2022. (Yuki IWAMURA / AFP)

Dr. Roy Zucker, a specialist in infectious diseases and head of LGBTQ medicine at the Clalit health fund, told the Kan public broadcaster that action needed to be taken now to prevent a wider outbreak of the infection, which is currently mainly spreading between gay, bisexual and other men who have sex with men.

“There are 105 diagnosed cases in Israel. This is a low number at this stage and if we act correctly we can prevent a larger outbreak by focusing efforts and taking preventive action based on rapid diagnosis,” he said.

“There should be preventative treatment by isolating those infected and the vaccination of at-risk populations. Patients with findings that include new blisters, a rash or enlarged lymph nodes are recommended to consult with a doctor who will refer for a test if appropriate,” he said.

According to Kan, the Health Ministry believes that there are many undiagnosed cases of monkeypox in Israel, and will expand testing capabilities in the coming days.

Israel reported its first monkeypox case in May — in a man who apparently contracted it abroad — and communal spread was first detected last month. Cases are raising concerns, as the virus is contagious, and while often mild, can cause serious illness.

Monkeypox is characterized by a rash that can look like pimples or blisters, from which the virus can be transmitted, normally through skin-to-skin contact.

This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin (Cynthia S. Goldsmith, Russell Regner/CDC via AP, File)

The World Health Organization said Saturday that the expanding monkeypox outbreak in more than 70 countries is an “extraordinary” situation that qualifies as a global emergency, a declaration that could worsen the scramble for scarce vaccines.

Dr. Tal Brosh, coordinator of Israel’s Epidemic Management Team, told The Times of Israel last week that Israel’s initial vaccine rollout is aimed at stopping the spread among the most affected population so far — men who have sex with men.

However, Brosh stressed that sex isn’t the only contact during which monkeypox can be transmitted, and said that other skin-to-skin contact — such as between family members — could account for numerous cases as the virus continues to spread.

Brosh, who heads the infectious disease department at Assuta Medical Center in Ashdod, said a major concern is that if case numbers grow, some of those infected will be people with preexisting health conditions, including those who are immunocompromised.

Nathan Jeffay contributed to this report. 

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