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Monkeypox vaccination effort in L.A. County prioritizes first of two doses

LOS ANGELES, CALIF. - JULY 21, 2022. People line up get vaccinated against the monkeypox virus on Thursday, July 21, 2022, at Eugene Obregon Park in Boyle Heights. (Luis Sinco / Los Angeles Times)
A line for the monkeypox vaccine at Eugene Obregon Park in Boyle Heights. (Luis Sinco / Los Angeles Times)

Los Angeles County's monkeypox vaccination effort will focus for now on getting first shots into arms.

To be fully vaccinated against monkeypox, people need to get two doses of the Jynneos vaccine four weeks apart. Ward Carpenter, director of health services for the Los Angeles LGBT Center, said Friday that he received new guidance from the L.A. County Department of Public Health advising that giving out first doses should be prioritized over administering the second shot.

On its website with guidance for healthcare professionals, the department said it "asks that all providers prioritize administering first doses of JYNNEOS vaccine to eligible immunocompetent persons to protect as many at-risk people as possible. Second dose appointments should be deferred until more doses of JYNNEOS become available." A spokesperson confirmed the new vaccine prioritization via email.

"The county is officially changing the strategy to deferring second doses. This is a big change," Carpenter said. It will help get more people partial protection against monkeypox, but at the same time, "it's going to create a lot of anguish and concern among people who need their second dose."

"There is good science" to back that change, he said, and "we are in support of that recommendation, but what that means is the question will be on everyone's mind: How protected am I with the first dose?"

And the answer to that question is: No one knows right now. The vaccine currently being given for monkeypox is actually a smallpox vaccine (both diseases are caused by orthopoxviruses). Data show the vaccine is safe in humans and effective in animals and in test tubes. But it hasn't been tested on humans under these circumstances before.

"We just don't have good data on vaccine effectiveness, especially as it relates to sexual transmission," said Anne Rimoin, a professor of epidemiology at the UCLA Fielding School of Public Health and a member of the World Health Organization's emergency committee on monkeypox. "That's not to say it won't work. We just don't have enough data to make definitive statements."

The health department reopened its list of pre-registration slots for monkeypox vaccination appointments on Friday afternoon. If you are eligible and there are still appointments available, you can click this link to sign up: https://lacpublichealth.sjc1.qualtrics.com/jfe/form/SV_aY96Sxs2lUgUZb8.

The list closes when no more spots are available. The county has a newsletter that will send you an email when more spots have opened. You can sign up for that at the top of the page here: http://publichealth.lacounty.gov/media/monkeypox.

You must be 18 years or older and meet at least one of the following criteria to be eligible:

  • You are a gay or bisexual man or a transgender person who has had multiple sex partners in the last 14 days, including (but not limited to) having sex in exchange for food, shelter or other goods or needs.

  • You are on HIV PrEP medication.

  • You've had anonymous sex or sex with multiple people within the last 21 days at a commercial sex venue or other venue.

  • You've had high or intermediate exposure to monkeypox (the CDC has a list of what qualifies as exposure at those levels).

  • You've attended an event or venue where there was a high risk of exposure via skin-to-skin or sexual contact with people with monkeypox.

  • You are experiencing homelessness and engaging in high-risk behaviors.

  • You are a gay or bisexual man or a transgender person who's had gonorrhea or early syphilis in the last 12 months.

  • You are in jail and have been identified as high-risk by clinical staff.

  • You are severely immunocompromised — for instance, if you are undergoing chemotherapy, are on high-dose steroids or other immunosuppressants, or have advanced or uncontrolled HIV.

Right now, Carpenter said, your best bet for getting a monkeypox vaccine is to sign up for the county's alert newsletter and check the pre-registration link frequently for availability.

This story originally appeared in Los Angeles Times.