Survey shows strong intention to get monkeypox vaccine, but self-diagnosis issues

A study today in Eurosurveillance shows that 70% of men who have sex with men (MSM) surveyed in the Netherlands said they intended to be vaccinated against monkeypox, and 44% showed a strong intention to self-isolate afterwards the diagnosis.

The online survey, however, showed the challenges of self-diagnosis, with only 52.3% of participants able to correctly identify a picture of monkeypox lesions on the face. Participants were asked to view images of monkeypox, Staphylococcus infection, stage 2 syphilis or eczema.

Only eczema has been correctly identified as not monkeypox most often.

In the United States, federal authorities will make available an additional 1.8 million doses of the Jynneos vaccine next week.

Strong intention to vaccinate but weak intention to isolate

The new survey is one of the first to assess how European MSM perceive the outbreak and adds to the evidence that the monkeypox vaccine is in high demand in countries experiencing major outbreaks.

Of the 394 MSM surveyed, 43% (171) were under the age of 45, 6% (22) were living with HIV, and 66% (241) were using HIV pre-exposure prophylaxis (PrEP)

Overall, 70% of participants were “extremely likely” to receive the vaccine and 44% showed a strong intention to self-isolate after diagnosis until all lesions were gone, usually up to 21 days . Of the 178 respondents using PrEP, 73.9% were very likely to get vaccinated, compared to 71.3% of those not using PrEP.

For the lesion self-identification part, the researchers displayed four images of facial lesions and asked respondents to indicate what condition it might be. Eczema was most often correctly diagnosed (67%), while pictures of monkeypox and staphylococcus received a few correct answers but many false self-diagnoses (up to 48% and 58%, respectively).

Stage 2 syphilis was most commonly misdiagnosed as monkeypox (52%).

“Results of a survey including 394 MSM in the Netherlands showed that only about half of them were able to self-diagnose monkeypox from other skin lesions, showing that the self-diagnosis, especially of new diseases, can be difficult,” the authors wrote. .

“Based on our findings, policymakers and public health services should, in addition to focusing on vaccinations in their communication, aim to increase MSM’s intentions to self-isolate and their ability to self-isolate. -diagnose accurately.”

High throughput with lesion swabs

In a second study in Eurosurveillance, Spanish investigators examined 140 clinical samples to determine which yielded the highest positivity rates. The highest positivity rates (97%) came from skin lesions from any part of the body, followed by plasma, pharyngeal and anal swabs, they found.

Anal swabs gave positive results in 93.8% of cases, followed by plasma (91.9%) and oropharyngeal swabs (88%).

Testing from multiple sites on a patient also reduced the number of false negatives, the authors reported.

Europe remains an epicenter of the monkeypox outbreak, with a total of 19,429 cases in 43 countries, according to an update from the European Center for Disease Prevention and Control (ECDC). The ECDC report said 505 patients in Europe were hospitalized (5.8%), with three admissions to intensive care units. Two people have died from the virus.

HHS makes 1.8 million additional doses of Jynneos available

Today, the U.S. Federal Monkeypox Response Team said jurisdictions that adopt intradermal administration of the Jynneos vaccine and have used 90% of their vaccine supply will be able to order additional doses, as 1.8 million doses will be available early next week.

The Department of Health and Human Services (HHS) also today announced a new pilot program that will set aside 50,000 doses of vaccine from the Strategic National Stockpile for use in jurisdictions that host large events that attract MSM to upcoming weeks and months, such as PRIDE events. Two events over Labor Day, Black Pride in Atlanta and Southern Decadence in New Orleans, have been cited as future sites for vaccine pop-ups.

“This is important, this is innovative – how we will strengthen local efforts to meet people where they are and mitigate the spread of monkeypox,” response coordinator Robert Fenton said during the meeting. a press briefing.

Rochelle Walensky, MD, MPH, director of the Centers for Disease Control and Prevention (CDC), said US authorities have confirmed 13,500 cases of monkeypox in 49 states, as well as Washington, DC and Puerto Rico.

Walensky said 98% of US patients are men, with 93% of cases among MSM. The median age of case-patients is 35 years.

In other US news, Los Angeles County today said it would begin offering second doses of Jynneos to those who received a first dose. An estimated 8,000 people in that county are waiting for a second dose.

Los Angeles County and Fulton County, Georgia, seat of Atlanta, were both cited today by White House officials as places where intradermal injections of Jynneos have become the standard of care.