Do I really need to get a monkeypox vaccine now?

I asked epidemiologists everything I didn't understand, from who's high-risk to how it affects summer travel plans.

Medical syringes are seen with 'Monkeypox' sign displayed on a screen in the backgound in this illus...
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With so much misinformation out there regarding monkeypox, it’s hard to gauge just how worried we should be about contracting the virus. One thing is certain: Monkeypox is spreading faster than epidemiologists had hoped. According to the CDC, there have been more nearly 1,000 confirmed infections in the U.S. since the first case was recorded in May, most of which have been recorded in California, Illinois, and New York.

The good news: There are monkeypox vaccines available — but the rollout has been painstakingly slow and inefficient. In New York City, for example, few people have actually been able to get a hold of the promised doses; the NYC Health Department’s appointment scheduling website crashed almost immediately after going live, Bloomberg reported.

That doesn’t mean it’s time to panic. Monkeypox doesn’t spread as easily as viruses like COVID, and not everyone needs to be scrambling to get vaccinated just yet. But as a queer person who lives in a big city, knowing that monkeypox has been disproportionately affecting gay men (reminder, it is not a “gay disease” or an STI), I wanted to make sure I have the right info and am prepared to get the vax if I need it. I spoke with infectious disease experts to get answers to all the questions that you may be too afraid to ask.

How many monkeypox vaccines are there, and which one should I get?

The FDA has licensed two vaccines for monkeypox prevention: JYNNEOS (known as Imvamune or Imvanex) and ACAM2000. They’re both also good for warding off smallpox (a related, though more severe, virus), and folks born before 1972 might have already been vaccinated with ACAM2000.

Everyone else should definitely try and get JYNNEOS, which is the vax the Biden administration is currently making more of, because it has the least side effects. In fact, doctors and the FDA don’t recommend ACAM2000 to people who are immunocompromised, because it contains a live virus that could cause fever and other unpleasant side effects.

If you’re also due for a COVID booster, try and “avoid getting the mRNA COVID vaccine and [the monkeypox vaccine] at the same time if possible, because there are some theoretical concerns and very rare side effects,” Dr. Stephen Morse, a professor of epidemiology at Columbia University, tells me.

Who should get the monkeypox vaccine first?

According to the CDC, high-risk groups eligible for the monkeypox vaccine include anyone who has a sexual partner who’s been diagnosed with monkeypox in the past 14 days, as well as anyone who’s had multiple sexual partners in the past 14 days in an area with with confirmed cases. Many states also recommend the vaccine specifically for men who have sex with men and have had more than one sexual partner in the past several weeks, per NBC News. If you’re a queer man who hasn’t gotten a lot of action in the past few months or are in a monogamous relationship, you’re not necessarily at the highest risk — but if you’re unsure, it’s always a good idea to consult a doctor.

While vaccines work best as preventative measures, if you suspect you’ve been exposed in the past few days and are beginning to show symptoms, try to get vaccinated ASAP. The vaccine can help prevent the virus from replicating and stop the worst effects of the virus, according to Morse.

Should I avoid going to gay parties until I get the monkeypox vaccine?

Short answer: No. Queer community is still important, and monkeypox is not a virus that exclusively affects LGTBTQ+ people — so don’t be afraid of being in a queer space just because of the monkeypox (you should be way more concerned about COVID in those situations). That said, it’s possible for people to have lesions or rashes on parts of their body that are easy to come into contact with. “You could have lesions in places on your hand,” Morse says, “although in general, the risk is very small.”

If you just want to go to the club and dance — keeping it PG — you probably won’t have a problem. But, Morse notes, that depends on “whether [you’re] able to go to a party and be attracted to someone and not get into more intimate activities.” That type of self-control can get more difficult a couple of drinks deep.

Daniel Pastula, an associate professor of epidemiology at the University of Colorado, explains that it also depends on what kind of space you’re going to. “[Monkeypox is] not airborne, you’re not going to get it from being in a room with someone,” he tells me. But, he continues, “dance clubs, raves, or places where people might not be fully clothed or take their shirts off [means that] all of a sudden you have a lot of skin-to-skin contact.” In other words, going clubbing, while clothed, in a venue that isn’t super packed is likely safe. A shirtless pool rave in Ibiza, on the other hand, might be considerably riskier.

Is monkeypox an STI?

Technically no — skin-to-skin contact, sexual or not, is all you need to get the virus — but this latest outbreak has been behaving in a way that does resemble an STI. “Historically, monkeypox starts as a fever, headache, swollen lymph nodes, and then a rash develops sort of at the face, and then descends,” Pastula says. “What we’re seeing with this outbreak is a little different. Some people have that blister or rash occasionally start around the genital or anus even before they have other symptoms.” Pastula tells me that as far as he knows, other monkeypox outbreaks haven’t spread primarily through genital-to-genital contact, which makes the current situation different and concerning.

Of course, there’s always the danger of stigmatizing monkeypox as some sort of gay disease, in the way that HIV once was. But the reason this virus is mostly affecting gay men basically comes down to bad luck: Gay men primarily interact sexually with other gay men, so the virus is naturally going to spread within that community. The last monkeypox outbreak in the U.S. was in 2003, and the main culprits were pet prairie dogs in the Midwest — so that time, people who had prairie dogs as pets were the most affected by monkeypox.

I’m traveling to Europe soon. Should I get vaccinated before my trip?

This current monkeypox outbreak has reportedly been traced to some gay raves in Europe — so does that mean people traveling there this summer need to be extra vigilant? Morse puts it bluntly: “It depends on what [you] plan to do when [you] get there.”

In other words, it’s all about that close contact. “[For] general travel where you’re not having skin-to-skin contact or saliva contact, it’s incredibly low risk,” Pastula says. If you’re just going to sightsee and hit up cafes, you probably don’t need the monkeypox vaccine before your trip. If you expect to taste the local flavor in other ways, though, you should prioritize getting the jab first.

Pastula also recommends asking partners you hook up with during your vacation if they’ve recently experienced symptoms like fevers, headaches, rashes, or anything else that might suggest a recent monkeypox infection. Condoms might be helpful to an extent, Pastula says, but not if either partner has lesions that aren’t solely confined to the penis.

How can I get the monkeypox vaccine?

This, unfortunately, is a question without a satisfying answer. The U.S. is currently working on making more of the JYNNEOS vaccine; earlier this month, the Department of Health and Human Services ordered an additional 2.5 million doses. Unfortunately, though, they won’t be available until later this year and into 2023 — so there probably won’t be enough doses for everyone who wants one in the coming months. Make sure to stay up-to-date with your local health department, and visit its website daily, in case they add extra vaccination appointments or locations near you.

For now, the best way to avoid getting monkeypox is to be a little extra vigilant. You don’t need to avoid having sex or casual hookups altogether, but you should take precautions. To be fair, queer people have already been doing this with STDs for decades. Monkeypox is just another thing to be aware of, but not something to cause panic.