TRUST INDEX: If you’ve had the smallpox vaccine, do you need one for monkeypox?

‘Everybody is not at high risk right now,’ experts say only some people qualify for current vaccine

SAN ANTONIO – Questions about the monkeypox vaccine have flooded our KSAT Trust Index inbox: “Who needs it? Is it the same as the smallpox vaccine? Will the old vaccines still work?”

KSAT tapped Dr. Jason Bowling, an associate professor and infectious disease specialist in the Long School of Medicine at UT Health San Antonio and chief epidemiologist at University Health, to get those questions answered.

Bowling quickly confirmed the vaccine currently being used against monkeypox is a smallpox vaccine.

“It’s a newer vaccine that’s being used now. It is related. It’s considered the third generation smallpox vaccine, but it is also active against monkeypox,” Bowling said.

He said this current vaccine just received FDA approval in 2019, so it’s different than the older vaccines people received decades ago.

“They stopped using that in 1972. Then, in between, there was a second vaccine for smallpox that people might also be thinking about that really was just used for people that worked with the vaccine in labs,” Bowling said.

The current version was also mainly made for people who work in labs and to prepare if smallpox returns.

“The one people remember from way back, you used to get the skin reaction, which they called a take. And there were all these safety instructions that you had to use to prevent that virus from causing infection to other people in the house. You don’t have to worry about any of that with this newer vaccine,” Bowling said.

So the big question is if you got those older smallpox vaccines, are you protected against monkeypox?

“That’s a great question, and the short answer is, we don’t know, which is not a real satisfying answer,” Bowling said.

Bowling said boosters were recommended for the older vaccine after about 10 years.

“So that means if we start vaccinating people in 1972, really a lot of people would be due for that. That being said, there may still be some residual protection,” Bowling explained.

The problem is it’s hard to tell how much protection would still exist.

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Bowling has a definitive suggestion if you become eligible for the vaccine, meaning you’ve come into contact with monkeypox.

“If you’re exposed to a monkeypox case, even if you had that prior smallpox vaccine sometime in the past, you would still benefit from getting the new vaccine,” he said.

There is currently a very small group of people eligible for the vaccine since it’s in short supply.

“I know a lot of people wonder if they should get it right now. It is not recommended for everybody, and everybody is not at high risk right now,” Bowling said.

Texas A&M epidemiologist explains how MonkeyPox is transmitted

The people at the highest risk of being infected are those who come into prolonged, close contact or have direct skin-to-skin contact with someone else who is infected.

Currently, the primary route of transmission has been through direct contact during sexual encounters. So while monkeypox isn’t a traditional sexually transmitted infection, experts have reported this is a context in which people have prolonged contact, usually with extended skin-to-skin contact, facilitating transmission. People who live in the same household or who share bedding, towels, drinks or utensils with infected individuals are also at risk.

Bexar County originally had 1,000 doses of the vaccine and is already on a waitlist for more.

“Recommendations on who should get the vaccines can change. But right now, I’m still not aware of any plans to make a general sweeping recommendation for it to go out to everybody. They just haven’t seen the spread that fast so far,” Bowling said.

There are multiple tiers of eligibility for the vaccine:

Priority Group 1 includes exposed individuals identified through contact tracing.

Priority Group 2 includes people with presumed exposure who:

  • Know that a sexual partner in the past 14 days was diagnosed with monkeypox
  • Attended an event or venue in the past 14 days and had a high-risk of exposure to someone with confirmed monkeypox through skin-to-skin or sexual contact

Priority Group 3 includes

  • People living with HIV
  • People on PrEP for the prevention of HIV

NOTE: Vaccines for Priority Group 3 are available from select health care providers by appointment and only to those who meet the criteria listed above and have not had monkeypox symptoms. Please check with your health care provider to see if they have vaccines available.

In the meantime, experts say in areas of higher transmission, you can limit direct skin contact with widely shared public spaces, like seats in public transportation, benches or other high-touch surfaces. That can be easily accomplished by wearing longer pants and sleeves in lieu of shorts and tank tops. Stepping up hand hygiene throughout the day is also encouraged.

For more information on monkeypox in our area, head to San Antonio Metro Health website’s monkeypox section.

To see more Trust Index stories or to submit your own question head to the KSAT Trust Index page.

About the Authors

Courtney Friedman anchors KSAT’s weekend evening shows and reports during the week. Her ongoing Loving in Fear series confronts Bexar County’s domestic violence epidemic. She joined KSAT in 2014 and is proud to call the SA and South Texas community home. She came to San Antonio from KYTX CBS 19 in Tyler, where she also anchored & reported.

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