Mpox

Vaccination against mpox

Experience of other jurisdictions shows early use of vaccines among groups who are at the highest risk of spread, along with case and contact tracing efforts by Public Health, can reduce transmission, prevent severe illness and limit risk to the wider population. Vaccine is not recommended or available for the general public. 

Eligibility:

Eligible individuals are Two-Spirit and transgender people and cisgender males who self-identify as belonging to the gay, bisexual and other men who have sex with men community and answer yes to any of the criteria below:

• Has sex with more than one partner, or
• Has sex with a partner who has more than one partner, or
• Has casual sex (e.g. cruising), or
• Engages in sex work or plans to, either as a worker or a client.

The vaccine cannot be administered to people who have symptoms that could be due to mpox. Instead, find a location for testing at https://smartsexresource.com/get-tested/clinic-finder 

To book an appointment please call our central booking line to schedule an appointment at select health units:

• Residents of Fraser East (Mission, Abbotsford, Chilliwack, Agassiz and Hope), call 604-702-4906.
• Residents in any other area of Fraser Health, call 604-476-7087.

Misidentifying oneself as eligible for mpox vaccine directs this critical tool away from people most at risk, limits its utility in preventing onward transmission and from protecting the wider population from a bigger outbreak.

The vaccine is not available to individuals of any gender who are not part of the community of gay, bisexual and other men who have sex men, unless they have been identified as a close contact of a confirmed case. 

Second doses

A second dose of mpox vaccine is now available to those who have received a first dose.

If you received your first dose and had a lab-confirmed mpox infection, you do not need a second dose.

For better, longer lasting protection get a second dose at least 28 days after your first dose.

Your protection is not reduced if you receive a second dose more than 28 days after a first dose. You don't need to start the series over if it's been longer than 28 days since your first dose.

Those who meet eligibility criteria for the mpox vaccine, but haven’t received their first dose yet, are also encouraged to get vaccinated.

Background

Since May 2022, one of the African strains has spread to more than 70 countries where mpox is not endemic, including in Canada. The pattern of spread in this global outbreak has been different: it is primarily human-to-human, sexually associated transmission.

In this global outbreak of mpox the primary mode of transmission is via close, skin-to-skin contact with a mpox rash.

On January 9, 2023 the mpox outbreak was declared over in B.C., however the virus may be transmitted through travel or spread locally. Learn more about current situation updates for Canada and British Columbia, including case counts.

According to the World Health Organization (WHO), 98 per cent of the cases in this global outbreak identified to date are among men who have sex with men; in B.C., all cases reported to date are among this demographic. While other people — including those living in the same household or those who have close skin-to-skin contact with a person who has mpox — may be at risk of infection, transmission from this type of contact has been infrequent to date.

To reduce local transmission, prevent severe illness and limit risk to the public, Public Health has an ongoing vaccine campaign, working with the BCCDC and community partners like Health Initiative for Men (HiM) and others, to provide information and vaccine to people most at risk of infection.

Vaccine is not recommended or available for the general public.

How mpox is spread

The mpox virus does not spread easily from person to person the way some viruses do, such as the virus that causes COVID-19. In this global outbreak of mpox the primary mode of transmission is via close, sexually-associated skin-to-skin contact.

Symptoms

Symptoms for mpox usually appear one to two weeks after exposure but can take anywhere from five to 21 days to appear and can last up to two to four weeks.

• The infection may start with flu-like symptoms including:
  • Fever or chills
  • Swollen lymph nodes
  • Intense headaches
  • Muscle aches
  • Back pain
  • Fatigue
• One to five days later, a skin rash appears, with lesions that can appear on genitals, hands, feet and/or mouth. The rash may start in one place and spread to other parts of the body.
• Some people only get the rash and in some people it may be limited to one or more lesions in the genital area.

People are considered to be infectious from when symptoms first appear until the sores crust over, are dry and new skin is visible. If the person does not have a rash, but have other mpox symptoms, their infectious period ends when symptoms resolve.

Get tested for mpox

People experiencing symptoms of mpox can be assessed to see if they need testing via their primary care provider, at Sexual Health clinics or at an Urgent and Primary Care Centre. If possible, the clinic should be informed ahead of time about the reason for the visit. 

Sexual Health clinics can be found using the BCCDC SmartSexResource clinic finder.

Until they see a health care provider, while awaiting results and if they are confirmed positive, these prevention measures should be followed when around other people:

• Wear a mask
• Keep any sores or blisters covered as much as possible (e.g. long sleeves, long pants)
• Limit close contact, including with people you live with and sexual contact with others
• Practice good hand hygiene
• Try to avoid sharing items or spaces while infectious, but if you need to, wipe down items and surfaces after using them
• Do not share towels, clothing, or linens

If you have been in close contact with a person with a mpox infection, monitor for symptoms. Symptoms can start five to 21 days after exposure.

Managing symptoms

Mpox is usually a mild illness and most people recover on their own after a few weeks. However, some people may experience moderate or severe disease and will need to see their health care provider. People experiencing more severe disease may require medications to manage pain or skin infections, or in rare cases, need other supportive treatment in hospital.

Please see your health care provider or go to your nearest Urgent Primary Care Centre if you experience the following after testing positive for mpox:

• Worsening or new throat or rectal pain
• Severe fever or chills
• Shortness of breath or chest pain 

Resources

• BCCDC - Mpox information page
• Health Canada - Monkeypox Outbreak Update Page 
• Information for healthcare providers about monkeypox - BC Centre for Disease Control 
• Social Gatherings, Safer Sex, and Monkeypox - US Centres of Disease Control and Prevention (CDC)
• NACI - Interim Guidance on the use of vaccine for monkeypox