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NPF Monkeypox Q&A

The NPF Medical Board addresses key questions about monkeypox for people living with psoriatic disease.

You’ve probably heard mention of monkeypox recently in the news or among friends and wondered what this new outbreak means for you, especially if you are living with psoriatic disease. The National Psoriasis Foundation Medical Board has worked to answer your questions and will continue to monitor this situation and how it affects our community.

Q: What is monkeypox?

A: Monkeypox is a rare disease caused by infection with the monkeypox virus. The monkeypox virus is a part of the same family of viruses as variola virus, the virus that causes smallpox. The symptoms of monkeypox are similar to smallpox, but milder. Infections with the type of monkeypox virus identified in this outbreak – the West African type – are rarely fatal, but people with weakened immune systems may be more likely to get severely ill. Monkeypox is not related to chickenpox.

Q: What are the symptoms of monkeypox?

A: Fever, headache, muscle aches and backache, swollen lymph nodes, chills, exhaustion, and a rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.

Talk with your health care provider if you have symptoms of monkeypox, even if you don’t think you came into contact with someone who has monkeypox.

Q: How is monkeypox spread?

A: Monkeypox is spread through skin-to-skin contact. This means it can be contracted through touching an infected person's rash, scabs, or bodily fluids. It can also be spread through items that have touched an infected person's rash or bodily fluids.

Q: Am I at a higher risk of contracting the monkeypox virus because I have psoriatic disease (psoriasis and/or psoriatic arthritis)?

A: There is no evidence currently to show that individuals with psoriatic disease are at a higher risk of contracting the monkeypox virus.

Q: Am I at a higher risk of having a severe monkeypox infection because I have psoriatic disease?

A: Patients with psoriasis, including children under the age of 8, and those taking oral or injected medications for psoriasis that may suppress the immune system, could potentially be at higher risk of severe disease with monkeypox, although more data is needed.

Q: Is there a vaccine to protect me against a monkeypox infection?

A: Yes, there are two vaccines approved by the U.S. Food and Drug Administration (FDA) to prevent monkeypox infections, JYNNEOS (also known as Imvamune or Imvanex) and ACAM2000. Individuals with psoriasis should not use the ACAM2000 vaccine.

Q: Should I get a monkeypox vaccine?

A: The CDC is currently recommending individuals who have been exposed to the monkeypox virus or are at a higher risk of being exposed to get vaccinated. Eligibility for vaccination may change as more vaccines become available.

Q: Is it safe to receive a monkeypox vaccine if I have psoriatic disease?

A: Based on CDC guidance, the ACAM2000 vaccine is contraindicated for many patients with psoriasis, especially those with severe disease or on any form of immunosuppression. The ACAM2000 vaccine should not be given to individuals who have cardiac disease, an eye disease treated with topical steroids, are pregnant, have a weakened immune system – including those taking a medication that suppresses the immune system, individuals who are living with HIV, or an acute, exfoliative skin condition such as psoriasis.

The JYNNEOS vaccine can be safely administered to individuals who are pregnant, have a weakened immune system, or an exfoliative skin condition such as psoriasis, and children under 18 years of age who have been exposed to monkeypox. However, individuals with immunocompromising conditions may be less likely to have an effective response after any vaccination, including JYNNEOS.

You should talk with the health care provider treating your psoriasis and/or psoriatic arthritis before receiving the JYNNEOS vaccine. Your health care provider should discuss the use of vaccines in a child with the state or local health department and CDC.

Q: How can I get a vaccine for monkeypox?

A: Talk with your health care provider if you think you are at risk of contracting the monkeypox virus and would like to get vaccinated. For children under the age of 18, your health care provider should discuss the use of vaccines with the state or local health department and CDC.

Q: Does the smallpox vaccine prevent monkeypox infections?

A: The smallpox vaccine may reduce your risk of developing a monkeypox infection, however the U.S. stopped vaccinating individuals for smallpox in 1972, so those under the age of 50 are likely to not have received a smallpox vaccine.

Q: What should I do if I have psoriatic disease and get infected with the monkeypox virus?

A: Follow all guidance from your local health professionals and health care provider. Monitor your symptoms and talk with your health care providers about if it is safe to continue using your psoriatic disease treatments while you are sick.

Q: Is there a treatment for a monkeypox infection?

A: There is no treatment specifically for monkeypox infections. There is a treatment, tecovirimat (also known as TPOXX or ST-246), that is approved to treat smallpox infections. Because smallpox and monkeypox infections have similarities, this drug may be used to help treat monkeypox infections. Per CDC guidance, it is recommended that this treatment be given to patients who have severe disease or are at risk of severe disease. This includes people with exfoliative skin conditions like psoriasis, immunocompromising conditions, pediatric populations – particularly those under 8 years of age, individuals who are pregnant, or have 1 or more complication.

Talk with your health care provider if you have symptoms of monkeypox or are already infected with it and would like to receive the treatment tecovirimat. Your provider will decide if it is right for you depending on the severity of your disease, your health history, availability of the treatment, and other factors.

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