Monkeypox: It's not an 'easily spread' disease, so what's the risk to Kiwis as it seeps in with no vaccination secured yet?

Monkeypox has begun to trickle its way into Aotearoa, with the Ministry of Health reporting a third case of the viral zoonotic disease this week. So what vaccines are available and what risk does the disease pose to Kiwis?

So far, all cases reported in Aotearoa are in those who have returned from overseas and we've not yet seen any cases come from their close contacts.

The Ministry of Health outlines on their website that monkeypox isn't an "easily spread" disease.

For monkeypox to be transmitted, it requires sexual or intimate contact with an infected person, contact with clothing, bedding or towels used by an infected person, and direct contact with monkeypox skin lesions or scabs.

An epidemiologist at the University of Otago, Professor Michael Baker, told Newshub that because of the intimate way monkeypox is transmitted the risk remains "very low". 

National director of the National Public Health Service Dr Nick Chamberlain agreed, but told media on Thursday that community transmission is inevitable. 

"We will undoubtedly see more cases imported to New Zealand and at some stage, we will see community transmission." 

At this point, Aotearoa hasn't yet secured a vaccine for monkeypox, but health officials and Prime Minister Jacinda Ardern are confident current public health measures are enough.

"It is a notifiable disease. Using isolation and contact tracing, that is successfully working for us, it has stopped community transmission. All of our cases continue to be those who have picked up monkeypox overseas."

Prof Baker agreed and he told Newshub that isolation and contact tracing aren't foreign concepts for Kiwis. 

"We've got all the tools we need to combat this threat effectively." 

So where is the vaccine and how might it be rolled out? 

Dr Chamberlain outlined that Health New Zealand and Pharmac have been seeking vaccines and anti-virals since Aotearoa's first monkeypox case in early July.

"The vaccines are only manufactured by one company in the world and there is a global shortage." 

The vaccine is only available to national suppliers and it can only be purchased in large quantities. Dr Chamberlain said for that reason there is a huge amount of international demand. 

Dr Chamberlain said authorities are actively working to secure at least 20,000 doses of the vaccine.

He signalled that Aotearoa's national immunisation programme is in the development of a vaccine implementation plan for when our vaccine order arrives, but it is unlikely we would see a vaccination campaign ahead of community transmission. 

"It's an important tool but certainly not the only one to prevent community spread."

When the vaccine does arrive in Aotearoa we may not see a widespread national vaccination campaign. Instead, Ardern said it would likely be targeted campaigns instead. 

"Vaccine, as I understand, is mostly being used amongst those who are at risk of coming into contact with monkeypox," Ardern said. 

"We would likely experience the same when we do secure supply."

With 98 percent of monkeypox cases being in gay or bisexual men, Prof Baker said it is likely the LGBTQ+ community will be a targeted vaccination group.

"The vaccine will be used for sexual health workers, gay, bisexual men, members of the LGBTQ+ community and contacts of cases." 

He said ring vaccinations could be a possibility too. 

"If you have an infected person who has contacts, you can vaccinate them even after they've been exposed."