It’s time to get vaccinated for mpox: Health experts urge care as Pride Month starts

Local clinics and public health experts are urging New Yorkers at risk for mpox to get vaccinated and take other precautions as Pride Month gets underway, given a recent uptick in cases.

The city health department and infectious disease experts say widespread availability of tests and vaccines mean New York City is much better-equipped to handle the disease — which can cause rashes, sores and flu-like symptoms — than during an outbreak that grew quickly during Pride Month in 2022 and continued through the summer. But some LGBTQ+ activists say they worry the cost of obtaining the vaccine through the commercial market and long waits for immunizations at city health clinics could still keep some people from getting protected.

Anyone who has close contact with a person who has sores or a rash from mpox — previously known as monkeypox — can contract the virus, but health officials say the vast majority of cases are among men who have sex with men and transgender individuals.

The city had recorded 191 cases of mpox this year as of May 9, the most recent date reflected in its online tracker. That’s more than was recorded in all of 2023, although daily case counts remain in the single digits, according to latest city data. A deadlier version of the virus that’s spreading in the Democratic Republic of the Congo is also raising concerns, even though it has yet to show up in other countries, said Dr. Wafaa El-Sadr, an epidemiologist with the Columbia Mailman School of Public Health.

“Everybody knows that we're an interconnected world and there's absolutely no reason why something that's happening in one country is not going to spread elsewhere,” she said.

The variety of mpox that arrived in New York two years ago typically produces a rash or sores that can initially look like pimples or blisters and may also bring flu-like symptoms like a fever or sore throat, according to the city health department.

New Yorkers should avoid close contact or sharing items with those who have rashes that could be mpox, and should visit doctors if they experience any symptoms themselves, El-Sadr said. And those who haven’t gotten vaccinated or have only gotten one dose of the two-dose mpox vaccine series should get a second dose now — even if they got the first dose a long time ago, she added.

The mpox vaccine is up to 75% effective at preventing transmission after one dose and up to 85% after two doses, according to JYNNEOS, the manufacturer.

While the vaccine isn’t perfect, it likely helped keep case counts down during last year’s Pride celebrations, said Dr. Angelica Cifuentes Kottkamp, an infectious disease specialist at NYU Langone who has studied the mpox vaccine.

“We were in the same position last year, when after the outbreak of 2022, we were thinking that we may again see cases rising during the summertime,” Cifuentes Kottkamp said. “Thankfully, the number of cases remained lower.”

People who have been vaccinated already should still remain vigilant, though, said Dr. Marcus Sandling, the clinical director for Callen-Lorde, a network of health clinics catering to the LGBTQ+ community.

“Patients who have been previously vaccinated or previously had mpox might have much less severe symptoms [if they contract the virus again] and so they should still have a high degree of suspicion if they're having a new or unusual rash on their body,” Sandling said. He said it was still important for those who have mild symptoms to get tested and try to avoid spreading the virus to others.

Access to the vaccine

Some advocates are worried about ongoing access to the mpox vaccine as its distribution and payment methods change. Previously, the vaccine was distributed directly from the federal government to local governments, which doled it out to health care providers at no cost.

As of April 1, health care providers are expected to purchase the vaccine directly from the manufacturer and bill doses to patients’ insurers. But Sandling said not all insurers are currently covering it.

“There are sometimes kinks to work out with insurance coverage that can either cause delays or cause changes in pricing,” he said.

Patrick Gallahue, a spokesperson for the city health department, said the agency has continued to distribute mpox vaccines to providers while the commercial supply ramps up.

Sandling said the free supply Callen-Lorde has received from the city is likely to last through the summer so that the clinic can provide free vaccines to patients whose insurance doesn’t provide coverage.

Activists with Act Up, an organization that has historically organized to fight AIDS, say they are concerned about people potentially having to pay out of pocket for the mpox vaccine as it switches to the commercial market, and about capacity at the city’s sexual health clinics. Two of the city health department’s eight clinics are remain closed after being shut down and repurposed for COVID-19 testing and vaccinations. And wait times can be long at other sites, said Brandon Cuicchi, an Act Up organizer.

“You just have to go in early and line up, and if you don't get seen, you don't get seen, and that's a terrible way to deal with an outbreak that's happening again,” he said.

Gallahue did not respond to specific concerns about the city’s capacity at sexual health clinics or say when the ones that are closed would reopen, but he said in an email that the city is “in a much better place than 2022 thanks to the many New Yorkers who got vaccinated.”

The city has a list of clinics offering the mpox vaccine on its Vaccine Finder website.