Vaccination to help protect against monkeypox

Monkeypox is a rare viral infection that usually causes a high temperature (fever) and a body rash that lasts a few weeks.

The risk of catching monkeypox in Scotland is low.

The vaccine

Monkeypox is caused by a virus similar to the one that causes smallpox. So vaccines designed for smallpox are considered effective against monkeypox.

The vaccine used in Scotland contains a virus that's been modified so that it cannot grow in the human body. This Modifed Vaccinia Ankara (MVA) vaccine is a much safer form of the smallpox vaccine. It's not specifically licensed for the prevention of monkeypox in Europe, but it's been used before in the UK against monkeypox.

Imvanex is the brand name for the Modifed Vaccinia Ankara (MVA) vaccine.

Read the IMVANEX patient information leaflet

The vaccine helps the immune system produce antibodies against the smallpox virus. This means the body’s natural defence system makes its own protection.

MVA vaccines do not contain the smallpox virus. They cannot spread or cause smallpox. The UK Health Security Agency (UKHSA) and the Joint Committee on Vaccination and Immunisation (JCVI) recommend the MVA vaccine to help prevent monkeypox.

No vaccine is 100% effective so you should still take precautions if you're vaccinated.

Who is offered the vaccine?

People at higher risk of coming into contact with monkeypox will be offered the vaccine to help reduce the spread.

There's currently a limited supply of the vaccine. So it's being offered to those at highest risk first. As more supplies become available, more people will be offered a first dose.

Scotland’s sexual health services have started contacting people at highest risk to offer vaccination. They'll continue to invite eligible groups over the next few months. This may be done by phone or at your next appointment, for example for PrEP or hepatitis B.

Before being exposed to monkeypox (pre-exposure)

The vaccine may be recommended to people at highest risk before they come into contact with monkeypox. This includes:

  • gay, bisexual and other men who have sex with men who are at higher risk including those who have multiple partners, take part in group sex, attend sex on premises venues, or have had a bacterial STI in the past year, for example chlamydia, gonorrhoea or syphilis
  • some healthcare workers in high-risk settings where they may care for a patient with monkeypox

A single dose of vaccine should be offered as soon as possible. A second dose may be offered at least 28 days after the first dose for those at risk of ongoing monkeypox exposure.

If you work in a setting where you're in contact with people at higher risk of monkeypox (like sex on premises venues), you may be invited for vaccination.

After being exposed to monkeypox (post-exposure)

If you've had significant contact with someone with monkeypox, you may be offered the vaccine. This includes healthcare workers or through sexual contact.

The vaccine is most effective when given within 4 days from the date of exposure. However, it can be given up to 14 days after exposure if you're at high risk of ongoing exposure or at risk of more severe disease. This may reduce your symptoms but may not prevent disease.

You'll be offered 1 dose of the vaccine. You'll be advised if you need any further doses.

How is the vaccine given?

You'll usually be given the vaccine as an injection in the upper arm.

Where can I get the vaccine?

High-risk healthcare workers will be offered the vaccine from their employer.

If you're in another high-risk group, some specialist sexual health clinics are offering the MVA vaccine.

Can I pay for an MVA vaccine privately or at a pharmacy?

No, the MVA vaccination is only available through the NHS to eligible groups and it's a free vaccination.

Is the vaccine safe?

MVA vaccines meet the required standards of safety and effectiveness. Vaccine safety continues to be monitored once it's in use.

Are there any reasons I cannot have the vaccine?

You should not have the vaccine if you've previously had a sudden life-threatening allergic reaction (anaphylaxis) to either:

  • a previous dose of the MVA vaccine
  • any ingredient of the vaccine, including those present in very small amounts such as chicken protein, benzonase, gentamicin or ciprofloxacin

It's also important to tell the person giving you the vaccine if you:

  • have a high temperature
  • have atopic dermatitis (atopic eczema)
  • are living with HIV or any other condition or treatment leading to a weakened immune system
  • are pregnant, planning to have a baby or breastfeeding

You can also let them know if you:

  • have a minor infection such as a cold
  • are taking or have recently taken any other medicines
  • have recently received any other vaccine

You can be given this vaccine even if you've received a smallpox vaccination in the past. But you may be at increased risk of side effects, so speak to the person giving you your vaccine.

Are there any side effects?

Like all medicines, the vaccine can cause side effects, but not everybody gets them. The common side effects are:

  • a headache
  • aching muscles
  • nausea
  • tiredness
  • chills
  • fever
  • joint pain, pain in the extremities (hands and feet)
  • loss of appetite
  • pain, redness, swelling, hardness, itching, discolouration, a lump or bruising at the injection site

Around 1 in 10 people may have chills and fever, but these should not last more than a few days. If you experience any of these side effects, you should rest and take paracetamol. Always follow the manufacturer's instructions. Do not take medicines containing aspirin if you are under the age of 16.

The most common side effects reported are at the site of injection. Most are mild to moderate in nature and cleared without any treatment within 7 days.

Fainting after vaccination is quite common. You should wait for 15 minutes after the vaccination before you drive.

If you have atopic dermatitis (atopic eczema), you may experience:

  • more intense skin reactions such as redness, swelling and itching
  • other general symptoms such as headache, muscle pain, feeling sick or tired
  • a flare-up or worsening of your skin condition

This information is only a guide. If you're concerned about any side effects, speak to your health professional or phone NHS 24 on 111 for free.

Immediate action required: Phone 999 immediately if:

You've had the vaccine and:

  • you have difficulty breathing
  • you have prolonged fainting, confusion or unconsciousness
  • your face, neck and/or tongue are swelling

These symptoms may be a sign of a serious allergic reaction and typically happen within 15 minutes of vaccination. Simple faints are much more common after vaccination. If you do faint, stay flat on your back with your legs raised. If this doesn’t make you feel better, then call for help.

Last updated:
26 July 2022