Following a recent cluster of at least 21 cases in Chicago, health officials and advocates are warning that mpox could spread again this summer, particularly in places where fewer people got vaccinated last year. A handful of those Chicago cases were linked to travel to New York City.
New Yorkers at risk for mpox (formerly known as monkeypox) should get vaccinated with two doses and be on the lookout for potential cases this summer, according to health experts. While the city has a high vaccination rate compared to other parts of the country, health experts remain concerned that large gatherings or travel could spur more cases in New York City, especially if people aren’t watching out for odd rashes and other symptoms.
This virus “is still circulating,” said Dr. Marcus Sandling, clinical director of sexual health at Callen-Lorde Community Health Center. People “could be at risk not only here at home, but also when they travel over the summer months,” he said.
Last summer, the city was a mpox hot spot, reporting about 75 cases a day during the outbreak’s peak. The disease primarily spread among the LGBTQ+ community through sex between men and other forms of close contact, such as hugging or cuddling. It’s not a sexually transmitted infection by definition, but some doctors, like Sandling, have started including it in their sexual health discussions with patients.
The most common mpox symptom is a painful rash, which can occur on the hands, feet, chest, face or near the genitals. Patients might also experience fever, chills, headaches and other flu-like symptoms, though mpox can also spread for up to 17 days before symptoms start. The disease can last for two to four weeks, according to the Centers for Disease Control and Prevention.
To get ahead of any mpox spread this summer, the city and state health departments have teamed up on a vaccination campaign. Health officials are particularly encouraging LGBTQ+ and other at-risk New Yorkers to get two doses of the JYNNEOS vaccine or to seek a second dose if they got one last year.
“The vaccine is more effective with both doses,” said Kraig Pannell, director of the state health department's office of LGBTQ Health Services, referencing recent studies from the state agency and the Centers for Disease Control. About 102,000 New Yorkers had received a first vaccine dose by the end of 2022, according to the city health department, but only half of them received a second dose.
In addition to vaccines, some health advocates said the city may need more preventative resources, such as mobile vans that could bring mpox services to Pride events. Experts will also track whether vaccine effectiveness wanes. Most of the people in the recent Chicago case cluster were vaccinated.
“We continue to monitor mpox cases here and elsewhere, and right now we have not seen an uptick in cases in NYC,” said Pedro Frisneda, a spokesperson for the city health department. The agency will be promoting mpox vaccines at Pride events and has planned a multimedia campaign later this month to promote sexual health services, including for mpox, Frisneda said. The city health department has also advised local doctors to watch for new cases, by sharing a CDC alert.
City officials should be proactive in talking to at-risk communities about mpox prevention, said Dr. Joseph Osmundson, a scientist and health advocate who worked on the response to last year’s outbreak. “Not just waiting for the cases to arrive, but actually reaching out to community now to set up the lines of communication.”
What to look out for this summer
Health officials say gay, bisexual and other men who have sex with men continue to be at higher risk for mpox, health officials say. In a recent modeling study, CDC scientists found that men living in areas with lower immunity due to fewer vaccinations and infections last summer are at higher risk for mpox infection in 2023.
Nearly 100% of at-risk men in Manhattan and Brooklyn have immunity for mpox, according to the CDC’s data. Men in the other boroughs or outside the city may be less protected: Only 36% of the Bronx’s at-risk population has immunity.
Osmundson is skeptical of the CDC’s modeling results, as both the Chicago cluster and cases in France earlier this spring included people who were fully vaccinated. “The big unknown now is, how protective is that vaccine going to be this summer, for people who received it last summer?” he said.
You have to meet people where they’re at.
CDC scientists are investigating any potential issues with the vaccine doses used in Chicago. They’re also checking whether the mpox virus may have mutated to evade the vaccine and other reasons why it may have become less effective. Health officials at all levels will be watching for more cases, which could shed additional light on the vaccine’s continued value.
Wastewater surveillance could also flag new mpox cases before patients show up at the doctor’s office, said Cristin Young, an epidemiologist and data scientist at Biobot Analytics.
Biobot works with the CDC on tracking mpox through sewage and has already identified some potential cases this spring, she said. New Yorkers can see these results on public dashboards run by the CDC and Biobot.
New York’s response
NYC residents can get vaccinated for mpox at the health department’s sexual health clinics in Chelsea, Corona, Fort Greene, Morrisania, and Jamaica. The Chelsea clinic is available for walk-ins, while the others require appointments. Other clinics offering vaccinations are listed on the NYC Vaccine Finder website.
There are plenty of doses available, Sandling said. Like the health agencies, he encourages his patients to get two doses for maximum protection. Despite the Chicago cases, he is “cautiously optimistic” about the vaccine’s effectiveness for preventing severe symptoms if not infections.
In 2022, the city health department and Health + Hospitals brought mobile vaccination vans to nightclubs and parties. These vans were “incredibly effective, and also eased some of the horrific disparities” around mpox, Osmundson said, though white New Yorkers were still vaccinated at higher rates than other groups.
Less funding is available for similar efforts this year, Osmundson said, due to the end of city and federal health emergencies. So far, the city health department has focused on sharing vaccine information, but it will monitor any need for additional resources, Frisneda said.
Outside the city, New Yorkers can get vaccinated through their local health departments and eight regional sexual health providers that are working directly with the state agency. The agency provided funding to these providers, as well as community advocacy organizations, to spread the word about mpox prevention.
Many New Yorkers might not know they’re still at risk for mpox, said Ace Sutherland, director of community organizing at Equality New York. Sutherland is working with the state health department on town halls, social media campaigns and other outreach initiatives.
“You have to meet people where they’re at,” Sutherland said, acknowledging that people will be attending parties and Pride events. “If you’re going to be outside, do it safely.”
Sandling additionally recommended that at-risk New Yorkers include mpox in their behaviors and conversations involving sexual health, such as asking partners about their sexual histories. “It's OK to have open and honest communication around this, not only with your partners, but also with your health care providers,” he said.
