(AGENPARL) – LONDON lun 27 giugno 2022

This guidance is intended for use by healthcare providers and professionals managing post-exposure vaccination clinics to help reduce the risk of transmission of monkeypox infection to other people during these clinics. Pre-exposure vaccination should be managed in the same way as routine vaccination using standard infection prevention and control (IPC) precautions.

This guidance provides advice on the risk assessment process and actions to be taken when individuals are travelling to and attending vaccination clinics. It should be read in conjunction with the national IPC manual.

Healthcare workers administering vaccinations for monkeypox are not required to be vaccinated against monkeypox.

Information on management of monkeypox contacts can be found in the monkeypox contact tracing guidance. Further background information on monkeypox is also available.

Risk assessment

Assess exposure date

Undertake an initial risk assessment of the individual via telephone before they attend the clinic in person to identify the date they were first exposed to a case of monkeypox.

The incubation period of monkeypox is 5 to 21 days.

There is currently no evidence that individuals are infectious before the onset of the prodromal illness.

Risk-assess for signs and symptoms of the infection

During your risk assessment, you should ask if the individual:

• has a fever (≥ 38°C)?
• has a recent onset of any new prodromal symptoms:
  • headache
  • backache
  • muscle ache
  • joint pain
  • chills
  • exhaustion
  • swollen lymph nodes
• has any evidence of new spots (even a few) or a rash
  • ask them to check carefully, including hands, feet and genital areas

If the individual does not have any clinical features of monkeypox infection they can proceed to be vaccinated.

If the individual has a fever or any of the other symptoms listed above, they are considered a possible case of monkeypox and should not attend for vaccination until there has been a further assessment. They should be advised to isolate at home and inform their designated UKHSA health protection team (HPT) contact on the number they have been provided with. The HPT will undertake a risk assessment and advise them on next steps.

If the HPT risk assessment considers that the contact does not meet any of the case definitions for monkeypox they can be reconsidered for vaccination.

Travel and vaccination clinic arrangements

Travelling to the vaccination clinic

Contacts who are advised to self-isolate should avoid using public transport or taxis to travel to the clinic. If possible, they should walk, cycle or drive. If these are not possible, they can be driven by a household member (if the household member is not immunosuppressed or pregnant). Where private transport is not available, public transport can be used, however, busy periods should be avoided.

Vaccination clinic

The clinic should be sited with a separate entrance and exit from all other users. A drive-through clinic could be considered. Individuals should be provided with a clinical contact number in advance.

On arrival at the vaccination clinic, individuals should not enter the hospital or clinic, but call the clinic to let them know they have arrived.

Individuals should be directed into the clinic via a dedicated route. Where clinics are unable to immediately receive the individual, they may be asked to wait outside and be called back when the clinic is ready.

On entering the vaccination clinic, the healthcare worker should take the individual’s temperature and ask if there are any of the symptoms above that might be indicative of monkeypox. If they do not have a fever or any of the other above symptoms, they can be taken into the vaccination room or clinic to proceed with vaccination. No specific personal protective equipment (PPE) is required and standard precautions, as used for any vaccination, are applicable. Standard hand hygiene should be followed, and any contact surface (chair and table) should be wiped down before and after each patient. Refer to the national IPC manual for further information.

Following vaccination, individuals should continue to follow the isolation advice they have been provided with.

If individuals remain well and do not have any further significant exposure, the second dose at 28 days can be given in routine settings.

0https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file//_monkeypox-contact-tracing-classification-and-vaccination-matrix.pdf’>https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file//_monkeypox-contact-tracing-classification-and-vaccination-matrix.pdf

Fonte/Source: https://www.gov.uk/guidance/monkeypox-reducing-risk-of-transmission-at-vaccination-clinics