Monkeypox information for health care providers

What providers need to know about monkeypox clinical guidance and smallpox/monkeypox vaccine (JYNNEOS™) administration, eligibility, and availability in Massachusetts.

Table of Contents

Clinical guidance

Vaccination

JYNNEOS vaccine administration

The JYNNEOS vaccine is shipped in 100 boxes of 20 doses each, in single-dose vials.

Vaccine is supplied to providers thawed and must be refrigerated at 2-8 degrees C for up to 8 weeks based on information provided by the manufacturer.

First Dose Strategy effective August 8, 2022

While the vaccine is approved as a two-dose series, given the severely limited national supply of JYNNEOS, the Massachusetts Department of Public Health and our vaccine partners are prioritizing first doses for as many people as possible. This approach is intended to provide the broadest possible protection against the spread of monkeypox virus in Massachusetts and is consistent with a growing number of states, jurisdictions and large municipalities.

For individuals with moderate to severe immune compromise (e.g. individuals living with HIV infection who are not virologically suppressed, persons on chemotherapy and individuals who have recently received an organ transplant), second doses should still be administered using the 28 day dosing interval. Second doses for others will be made available as soon as possible when more doses are available from the CDC.  A second dose given weeks to months after the primary dose will still result in boosting and provide long-term immunity.

Please note: as of August 8th, second dose appointments that are already scheduled will be honored and not cancelled; no new second dose appointments will be scheduled until additional vaccine is available.

Eligibility

Vaccination will be available to individuals who live or work in Massachusetts and meet the CDC’s current eligibility criteria, prioritizing those who are most at risk of exposure to an individual with monkeypox. This includes:

  • Known contacts identified by public health via case investigation, contact tracing, and risk exposure assessments (this may include sexual partners, household contacts, and healthcare workers); as well as
  • Presumed contacts who meet the following criteria:
    • Know that a sexual partner in the past 14 days was diagnosed with monkeypox
    • Had multiple sexual partners in the past 14 days in a jurisdiction with known monkeypox

While many of the identified cases are within networks of self-identified gay and bisexual men, other men who have sex with men, and transgender individuals who have sex with men, people of any sexual orientation or gender identity can become infected and spread monkeypox.

Availability

Administration of JYNNEOS will be by appointment only. Healthcare providers will be responsible for performing risk and exposure assessment prior to vaccination. 

For a list of monkeypox vaccine providers and appointment information, visit How to obtain vaccine.

ACAM2000

Please note that CDC has also made available the live replicating smallpox vaccine ACAM2000. This vaccine is available in larger quantities but has a number of characteristics that make it unsuitable for use in the current context, including considerably greater risk to the recipient compared with JYNNEOS. Local health departments and providers are not currently requesting ACAM2000.

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