MONKEYPOX / MPOX SINGAPORE
What is Monkeypox / Mpox?
Mpox is a rare viral disease caused by the Monkeypox/Mpox virus.
What are the symptoms of Mpox?
Symptoms of Mpox include:
- An unexplained acute rash
- Blisters or vesicles and pustules, especially around the genital area and anus
- Swollen lymph nodes in the neck, armpits and groin
- Other accompanying symptoms such as fever, headache, backache, myalgia and asthenia (profound weakness)
Incubation Period: Symptoms may appear within 5 – 21 days after exposure.
Most patients recover in 2-4 weeks but remain infectious until their vesicles or ulcers scab over, the scabs fall off and skin lesions heal completely.
However, complications of Mpox can occur and include secondary infections, bronchopneumonia (lung infection), sepsis (blood infection), encephalitis (brain infection) and infection of the cornea with ensuing loss of vision.
Individuals at higher risk for severe or fatal Mpox include immunocompromised persons (including HIV infection), pregnant women, and young children.
How is Mpox transmitted?
Mpox may be transmitted through sexual intercourse or through direct contact with skin, genital lesions or body fluids.
Mpox can also be transmitted through non-sexual routes:
- Skin to skin contact (rubbing up against each other in crowded areas)
- Face to face contact (kissing or close contact with infected person in crowded settings)
- Contact with contaminated materials e.g. linens, bedding, clothing, sex toys etc
MONKEYPOX / MPOX VACCINATION SINGAPORE
INFORMATION ABOUT THE JYNNEOS VACCINE
1) The JYNNEOS vaccine is a live but non-replicating viral vaccine, based on the Modified Vaccine Ankara Bavarian Nordic (MVA-BN) strain. This is considered a third-generation smallpox vaccine, which has efficacy in preventing smallpox, mpox, vaccinia and other orthopoxvirus infections. It cannot cause smallpox, mpox or any other disease.
2) The JYNNEOS Modified Vaccinia Ankara (MVA) vaccine, hereafter referred to as the JYNNEOS vaccine, is a suspension for subcutaneous injection, administered as a single-dose or a 2-dose series given 28 days apart. The dose consists of 0.5 mL in a single-dose vial.
3) Vaccine efficacy was inferred from immunogenicity data from clinical studies, and from efficacy data in animal challenge studies. Studies have also estimated that one or two doses of the JYNNEOS vaccine could provide around 80% protection against mpox, although current data is still limited to conclude on the level and duration of the protection conferred by vaccination.
4) JYNNEOS is approved by US FDA for prevention of smallpox and mpox in adults 18 years and older, who are at high risk for smallpox or mpox infection. Since August 9, 2022, JYNNEOS has been authorized by US FDA for people aged <18 years (subcutaneous injection) under an Emergency Use Authorization.
5) JYNNEOS vaccination is currently available in Singapore for the following indications:
| a) POST-EXPOSURE PROPHYLAXIS (PEP) | For persons who have already had unprotected close contact with a confirmed mpox case. |
| b) PRE-EXPOSURE PROPHYLAXIS FOR OCCUPATIONAL EXPOSURE (PrEP) | For healthcare workers and other staff with direct contact with mpox patients as well as potential exposure to mpox virus or fomites. |
| c) PRE-EXPOSURE PROPHYLAXIS FOR NON-OCCUPATIONAL EXPOSURE (PrEP) | For persons at high risk for potential exposure to mpox. |
6) For post-exposure prophylaxis (PEP), JYNNEOS vaccine should be given within 4 days of exposure for optimal effectiveness in preventing disease. If given 4-14 days after exposure, vaccination may be less effective in preventing disease but may still reduce disease symptoms or severity.
7) Persons who received smallpox vaccination in childhood before it was discontinued (in 1981 for Singapore, but this date may be different in other countries), may proceed for PEP or PrEP using the JYNNEOS vaccine, if eligible. Dosing recommendations in individuals with prior smallpox vaccination may differ from vaccine-naïve individuals.
8) Common adverse effects after JYNNEOS vaccination include redness, tenderness, swelling or itching at the injection site. Common systemic adverse effects include fatigue, headache and body aches.
9) The incidence of severe adverse effects (SAE) was low in the vaccine group and ranged from 0.1 to 4.2% with the highest frequency observed for fatigue. As with any vaccine, syncope or anaphylaxis can occur after vaccination.
10) Myocarditis has been reported as a rare SAE with COVID-19 vaccination, as a precaution, it is advisable to postpone COVID-19 vaccination for 4 weeks after receiving JYNNEOS vaccination. Conversely, if JYNNEOS vaccination is being given for post-exposure prophylaxis or in the context of high levels of community transmission but the patient recently received COVID-19 vaccination (within the past 2 weeks), JYNNEOS vaccination can proceed because the clinical risk-benefit to prevent mpox would favour giving the vaccine. No minimum interval between COVID-19 vaccination with these vaccines and JYNNEOS vaccination is necessary.
11) This Mpox vaccination program is offered under the joint direction of Communicable Diseases Agency (CDA) and Ministry of Health (MOH). This is a voluntary, self-funded mpox (JYNNEOS) pre-exposure prophylaxis (PrEP) vaccination programme for high-risk gay, bisexual and other men who have sex with men (GBMSM).
12) The JYNNEOS smallpox / mpox vaccine has been approved by the Health Sciences Authority (HSA) Singapore.
DOSING AND ADMINISTRATION
The JYNNEOS vaccine dose is 0.5 mL in a single-dose vial, to be administered subcutaneously. The number of doses to be administered is as below:
| Indication | Doses (0.5mL / dose) |
|---|---|
| Post Exposure Prophylaxis in Close Contacts | |
| 18 years old and above | Single dose @ day 0 |
| Pre-Exposure Prophylaxis | |
| 18 years old and above with childhood smallpox vaccination* | Single dose @ day 0 |
| 18 years old and above, vaccine-naïve | Dose 1 @ day 0 Dose 2 @ day 28 |
*These individuals are generally aged 45 years and above (as of 2024), as smallpox vaccination was no longer mandatory from March 1981 in Singapore.
GETTING VACCINATED AGAINST MPOX
Authorized Clinic
Tanjong Pagar Medical Clinic is authorized by Ministry of Health (MOH) to provide Pre-Exposure Prophylaxis (PrEP) Vaccination Program for Mpox Virus using MVA-BN JYNNEOS vaccine.
Eligibility
The JYNNEOS vaccine is offered to high-risk gay, bisexual and other men who have sex with men (GBMSM).
The eligibility criteria for “high-risk GBMSM” has been revised to “GBMSM with more than two sexual partners in the past six months”.
The JYNNEOS vaccine is available to any nationality or residential status (i.e. Singapore Citizen/Permanent Resident/Long Term Visit Pass Holder/Short Term Visit Pass Holder (Non-Resident).
Cost of MPOX Vaccination
For Locals and Residents:
- Consultation fee $30
- Vaccine fee $450 per dose
- Prevailing GST applies
For Non-Residents:
- Consultation fee $30
- Vaccine fee $550 per dose
- Prevailing GST applies
Booking Procedures
An advance notice of 5 – 7 working days is required for ordering and delivery of vaccine.
If you are interested in the mpox vaccination, please kindly contact us at 64433101 or 96622880 or email us at info@tanjongpagarclinic.com to schedule an appointment.
For Enquiries and Appointments
Other Services Available
| STD | HIV | VACCINATION | GENERAL | STATUTORY | MEN’S HEALTH | WOMEN’S HEALTH |
|---|---|---|---|---|---|---|
| STD TESTING AND SCREENING | HIV TESTING AND SCREENING | HPV (HUMAN PAPILLOMAVIRUS) VACCINATION | ACUTE AND CHRONIC DISEASES | LASTING POWER OF ATTORNEY (LPA) | HAIR LOSS ANDROGENETIC ALOPECIA | MENSTRUAL REGULATION |
| STD EXPRESS TESTING | HIV PEP (POST EXPOSURE PROPHYLAXIS) | HEPATITIS VACCINATION | HEALTH SCREENING | ADVANCED MEDICAL DIRECTIVE (AMD) | ERECTILE DYSFUNCTION | CONTRACEPTION REGULAR AND EMERGENCY |
| STD SELF TESTING | ANONYMOUS HIV TESTING | MPOX VACCINATION | SKIN AND ACNE | FOREIGN WORKER MEDICAL EXAM | PREMATURE EJACULATION | PAP SMEAR |
| STD TREATMENT | STD-HIV | ADULT AND CHILD VACCINATION | WEIGHT LOSS AND MANAGEMENT | DRIVING LICENSE MEDICAL EXAM | ANDROPAUSE TESTOSTERONE DEFICIENCY |
