Information and resources regarding the monkeypox outbreak
Monkeypox Vaccination Sites
Monkeypox Vaccination Sites
In May 2022, monkeypox was identified in the United States in a Massachusetts resident who traveled outside the country. Since then, monkeypox has been identified in nearly every state in the U.S. and in more than 80 countries where cases do not typically occur.
Monkeypox is rare and does not spread easily between people without close contact. The threat of monkeypox to the general U.S. population remains LOW.
Photo courtesy: UK Health Security Agency (UKHSA)
Symptoms are most often mild, but in rare cases a more severe illness can occur that might require hospitalization. See below resources and FAQs for more information.
- NH DHHS Updates Monkeypox Vaccine Eligibility (September 26, 2022)
- First Pediatric Case of Monkeypox Identified in New Hampshire (September 16, 2022)
- NH DHHS Expands Monkeypox Vaccine Eligibility, Vaccination Locations (August 29, 2022)
- First Probable Case of Monkeypox Identified in New Hampshire (June 29, 2022)
What is monkeypox?
Monkeypox is a rare disease caused by infection with the monkeypox virus. People with monkeypox get a unique rash that changes over time as a person’s illness progresses and then goes away. Other symptoms of monkeypox can include fever, chills, headache, exhaustion, muscle aches, sore throat, or swollen lymph nodes. Sometimes people may only have the rash.
Is monkeypox deadly?
The type of monkeypox virus causing the current outbreaks is not usually fatal, and most people will get better within a few weeks after developing symptoms. However, people with a weakened immune system, children under 8 years old, people with a history of eczema, and pregnant or breastfeeding women may be more likely to get seriously ill or die.
How does monkeypox spread?
Monkeypox usually spreads from person-to-person through direct physical contact with the infectious rash, scabs, or body fluids of another person who has monkeypox, including during intimate physical contact such as kissing, cuddling, or sex. The monkeypox virus can survive on surfaces, so spread can occur through contact with contaminated objects like bedding and clothing that has come into contact with another person’s infectious body fluids or skin lesion material. It can also spread from an infected person’s respiratory tract during prolonged face-to-face close contact.
When is someone with monkeypox contagious?
A person with monkeypox can spread their infection starting when they first develop symptoms, and they remain contagious until their rash has fully healed and a fresh layer of skin has formed. People who do not have monkeypox symptoms are not considered contagious or a risk to others.
Can I get monkeypox from talking with someone or being in a room with someone that has monkeypox?
Monkeypox is primarily spread through direct physical contact with another person who is sick with monkeypox or direct physical contact with their infectious body fluids. While monkeypox can be spread through respiratory droplets, this usually requires standing face-to-face with someone who is symptomatic for a long period of time. So briefly talking with someone or being in the same room with a person who has monkeypox is unlikely to cause to infection.
Is monkeypox considered a sexually transmitted infection?
It’s unknown at this time if the virus can spread through semen or vaginal fluids. We do know it spreads through direct contact with monkeypox sores which can occur during sex, massage or hugging.
How can monkeypox be prevented?
Be alert. Look for rashes or sores on people who you are planning on being in physical or intimate contact with. If they have a concerning rash, avoid physical or sexual contact. Avoid sharing eating utensils, plates or cups with someone who is sick or having symptoms of monkeypox, and avoid handling their clothing or bedding.
Avoid contact with other objects and materials a person with monkeypox has used.
Minimize skin-to-skin contact at crowded events or venues where people may not be wearing much clothing, or consider not attending such events. Wash your hands often with soap and water, or use an alcohol-based hand sanitizer, especially before eating or touching your face.
Anyone diagnosed with monkeypox should isolate at home until their symptoms are resolved to prevent further spread. Public health investigations may identify others who may have been exposed to monkeypox. If you receive notice of a possible exposure, watch yourself for symptoms. If you develop symptoms, call your local clinic or healthcare provider for testing.
For more information, visit the CDC’s prevention information at https://www.cdc.gov/poxvirus/monkeypox/specific-settings/social-gatherings.html
For People with Confirmed Monkeypox by Testing
How can people with monkeypox minimize the risk of transmission to others?
Anyone with monkeypox should:
- Stay home and away from other people and animals, including people and animals in the home
- Stay in their own room and use their own bathroom
- Limit touching commonly used objects or shared items in the home
- Clean and disinfect touched surfaces that other people may come into contact with
- Be careful how cloths and linens are laundered
- Practice frequent hand washing or use an alcohol-based hand sanitizer
- Avoid touching the rash; keep skin rash and sores covered
- Wear a well-fitting mask if contact with others cannot be avoided (e.g., when getting medical care or in a shared living space)
- Household members of a person with monkeypox should also wear a well-fitting mask to protect themselves if they need to be around the person with monkeypox (e.g., to assist with personal or medical care)
See CDC’s guidance for further details and instructions:
If I have monkeypox, how long do I need to isolate?
People with monkeypox should isolate at home until all lesions have resolved, the scabs have fallen off and a fresh layer of intact skin has formed. This could take up to 2-4 weeks from the beginning of symptom onset. If a person with monkeypox needs to leave isolation for any reason, that person needs to discuss the situation first with public health so we can help avoid exposing other people.
I was diagnosed with monkeypox, but am nervous to tell my partner(s).
You can tell your partners anonymously using the Tell Your Partner website: https://tellyourpartner.org
I have been diagnosed with monkeypox. What should i do regarding care of my pet?
Although there have been no reports of pets becoming sick with monkeypox in the United States, it is still recommended that people sick with monkeypox limit contact with animals, particularly rodents and lagomorphs, until more information is known about the presence and spread of the virus in the United States.
- When possible, another member of the household should care for the pet.
- The infected person should avoid contact with the pet, including petting, snuggling, being kissed or licked, and sharing food.
- If an infected person must care for the pet while they are sick, they should wear long sleeves, disposable gloves, and a face covering as well as washing hands before and after interacting with them. Making sure to cover rashes or other skin lesions associated with monkeypox virus infection should be done to limit the pet’s contact with virus.
- When the human owner is no longer infectious as determined by the public health official assisting with their monitoring, they can return to normal animal care practices.
Additional information about care for pets in the home of monkeypox infected persons can be found at https://www.cdc.gov/poxvirus/monkeypox/specific-settings/pets-in-homes.html
Cleaning & Disinfection
How should people with monkeypox clean and disinfect their home?
The CDC provides general guidance on cleaning and disinfecting the home. Please review the guidance at https://www.cdc.gov/poxvirus/monkeypox/specific-settings/home-disinfection.html.
Are there any special instructions for how to wash clothing and linens that have been in contact with a monkeypox rash?
People with monkeypox should handle their own laundry and keep it separate from the laundry of the other people in the home. Soiled laundry should never be shaken or handled in a way that could spread infectious particles. Laundry should be kept in an impermeable container that can be disinfected after, or in a fabric bag that can be washed with the clothing. Landry can be washed in a standard washing machine with regular detergent (follow label instructions). Avoid public laundry facilities.
See CDC’s guidance for more details: https://www.cdc.gov/poxvirus/monkeypox/specific-settings/home-disinfection.html
Go to State-by-State Case Counts (CDC)
Hover over New Hampshire for the number of cases or scroll down to the bottom of the page for a downloadable Excel file.
CDC Video on How to Administer a JYNNEOS Vaccine Intradermally
How to Administer a JYNNEOS Vaccine Intradermally (CDC)
How to Administer a JYNNEOS Vaccine Intradermally (CDC)
Transcript of video:
How to administer a vaccine intradermally.
Locate and clean a site for injection in the inner or volar surface of the forearm.
While pulling the skin taut, position the needle with the bevel facing up
and insert the needle at a 5 to 15 degree angle
into the dermis.
Slowly inject 0.1 milliliters intradermally.
This should produce a noticeable pale elevation of the skin,
Observe patients for 15 minutes after vaccination
or 30 minutes if they have a history of anaphylaxis to gentamicin,
ciprofloxacin, chicken, or egg protein.
Learn more at cdc.gov/monkeypox.
For People with Possible Exposure to Monkeypox
I think I was exposed to monkeypox - what should I do?
Call your healthcare provider right away and let them know you think you were exposed to monkeypox. Based on your situation, your healthcare provider can help determine if you might benefit from being given the JYNNEOS vaccine, which can help prevent infection if given early after an exposure. If you do not have a primary health care provider, please call (603) 271-4496.
How soon after exposure to monkeypox do symptoms appear?
If you have been exposed to someone with monkeypox, symptoms of infection will usually occur between 7-14 days after exposure, but this can range from 5-21 days.
If I have a rash or other symptoms suspicious for monkeypox after exposure, what should I do?
Call your healthcare provider right away and let them know about your symptoms and potential exposure to someone with monkeypox. Your healthcare provider will arrange for testing. You should isolate yourself from others until the test result is back. If you do not have a health care provider, please call (603) 271-4496.
Vaccine Questions (Pre-Exposure Prophylaxis and Post-Exposure Prophylaxis)
Is there a vaccine to prevent monkeypox?
Yes. The JYNNEOS vaccine is the only FDA-approved vaccine to prevent monkeypox and is given as a 2-dose series. The second dose is given 28 days after the first dose. People have maximal protection starting about 14 days after the second dose. Those who are vaccinated should still take precautions to avoid infection since the vaccine does not provide 100% protection (see recommendations above for preventing monkeypox). Even if vaccinated, people should avoid close or physical contact with someone who has monkeypox.
How effective is the JYNNEOS™ vaccine?
We don’t yet know the effectiveness of JYNNEOS in the current outbreak, but based on historical data the JYNNEOS vaccine is believed to be at least 85% effective at preventing monkeypox if the vaccine series is completed before an exposure occurs.
If someone is exposed to monkeypox and then vaccinated, the best chance of preventing infection is to receive the vaccine within 4 days of an exposure.We do not yet know the effectiveness of the vaccine when given within 4 days after an exposure. If the vaccine is given between 4 and 14 days after an exposure, the vaccination might reduce symptoms but is unlikely to prevent the person from becoming sick with monkeypox. Vaccination after the onset of symptoms of monkeypox is not helpful.
Is the JYNNEOS™ vaccine safe in patients who are pregnant or breastfeeding?
There is not much human data on use of the vaccine in people who are pregnant, but animal studies have shown no evidence of harm to a developing fetus. Similarly, the vaccine has not been studied in people who are breastfeeding or in young children. However, the risk to a breastfed infant from vaccinating the mother is likely low. Therefore, JYNNEOS vaccine can be given to people who are pregnant or breastfeeding if they are eligible to be vaccinated (e.g., after being exposed to monkeypox).
Who is eligible to get the JYNNEOS™ vaccine in NH?
To receive a vaccine, in New Hampshire, you must:
- Live in NH
- Work in NH, or
- Have a primary care healthcare provider in NH
NH DPHS recommends you receive the JYNNEOS vaccine if you:
1. Know you have been exposed to the monkeypox virus in the last 14 days, or
2. May be more likely to get the monkeypox infection (BEFORE being exposed to the virus), including men who have sex with men who reported:
- Having three (3) or more new sex partners in the last month,
- Engaging in group or anonymous sex,
- Having sex at sex-on-site venues/events,
- Taking medicine to prevent HIV (HIV PrEP).
NH DHHS will post updates on vaccine eligibility on monkeypox webpage.
Where can I get the monkeypox vaccine?
Because the JYNNEOS vaccine supply continues to be limited, persons seeking to get the vaccine will require an appointment.
• IF you HAVE a primary care provider, call your provider and ask if the vaccine is right for you.
If yes, ask your provider to make a referral to one of the listed clinic sites to schedule an appointment.
• IF you DO NOT HAVE a primary care provider, call one of the listed clinics on the website.
Can teens or children get the vaccine if they’ve been exposed to monkeypox?
Yes. Under the FDA’s Emergency Use Authorization (EUA), people younger than 18 years of age, at risk of getting monkeypox can be vaccinated. The JYNNEOS™ vaccine when given to children and adolescents is a subcutaneous injection (beneath the skin) in the upper arm.
Why are the FDA and CDC now recommending that the JYNNEOS vaccine be given in a different way?
Monkeypox virus infections continue to increase, and the number of vaccine doses that we have continue to be limited. To increase the number of people that can be vaccinated, the FDA and CDC are now recommending that adults 18 years of age or older who are at high risk for being exposed to the monkeypox virus be vaccinated with a lower dose of the JYNNEOS vaccine that is given between the top and bottom layers of skin on a person's forearm (called an "intradermal" injection). When the vaccine is given in this way, it has been shown to produce the same level of antibody protection compared to a higher dose of the same vaccine given beneath the skin layers (called a "subcutaneous" injection). Administering the vaccine between the skin layers (intradermally) can only be given in this way for adults 18 years of age or older, and it is an important way to increase the number of people who can be vaccinated (because of the lower dose used) while still offering a high-level of protection. Children and adolescents who may need to be vaccinated can also be vaccinated with the same JYNNEOS vaccine, but for people under the age of 18 years, the vaccine will still be given at the standard dose given beneath the skin (subcutaneously).
The vaccine is safe when it is given both ways, but people given the vaccine between skin layers (intradermally) may be more likely to develop local reactions, like redness, swelling, itching, or discomfort at the injection site. And those local reactions may last for a longer period of time.
What treatments are available for monkeypox?
Most illnesses are mild and resolve on their own without treatment. However, for people who develop more severe disease, or who are at high risk of developing severe disease (such as people with weakened immune systems and pregnant women), Tecovirimat® (TPOXX) may be recommended. Talk to your doctor to see if treatment is right for you.