Question for those who've received the Monkeypox vaccine

[Guest]

My man and I recently came back from a cruise, ending with a few days' stay in Provincetown. We met a few people in Provincetown who'd had the vaccines over the last few months, and most of them had scars in their anterior forearms. Having been born before 1974, I still have my smallpox vaccine scar over my left deltoid (shoulder), which seems to be a much preferable location, cosmetically. When getting the shot these days (presumably pretty identical to the one I received as a tiny tot), do they give you an option as to where on your body you'd like to get it? I'd definitely prefer to get it in my left deltoid, over or near my previous scar. 

[JonathanCAN]

JYNNEOS should not leave a scar behind.

It is possible some jurisdiction is administering the ACAM 2000 vaccine, which, as you noted, do leave a scar behind.

"Jurisdictions may also request shipments of ACAM2000 vaccine, which is in much greater supply, but due to significant side effects is not recommended for everyone."

https://aspr.hhs.gov/SNS/Pages/JYNNEOS-Distribution.aspx

[SirBillybob]

It’s odd that so many have anterior forearm marks, since the fractional dose intradermal method in that location of the body replaced the conventional dose subcutaneous route quite recently, usually given in the tricep area where my swollen redness (and others’, posting the same reaction on line) occurred in that location but resolved quickly. But it may be that the P-town fellows had recent vaccination of the later method and less time to fade?

I assumed the intradermal, one puncture, would leave a temporary wheal but not a lasting scar. I believe anterior forearm is the preferred location for the intradermal because those administering it likely tend to be experienced with Mantoux tests where I believe the needle comes in at the same shallow angle and with the needle bevel facing up. It seems to be a bit more technically demanding, therefore best invariant.

Also, apply no pressure to the area afterwards that would problematically distribute the product subcutaneously. You know how for venipuncture we apply pressure even with a bandaid? That’s a no-no even if a bandaid is administered that might prompt a knee jerk reaction of applying pressure as for blood draws.

Edited September 7, 2022 by SirBillybob

[Guest]

1 hour ago, SirBillybob said:

It’s odd that so many have anterior forearm marks...

I wouldn't say "many"--more like 3 that I noticed. One was the man sitting across from us on the ferry over, and I believe he said he had that shot 3 weeks prior. I'd hate not to have the option to choose a different location on my body. 

[SirBillybob]

1 hour ago, Unicorn said:

I wouldn't say "many"--more like 3 that I noticed. One was the man sitting across from us on the ferry over, and I believe he said he had that shot 3 weeks prior. I'd hate not to have the option to choose a different location on my body. 

I wasn’t aware of this phenomenon. Could it be a ‘keloid scar’ that might occur for some not others? The CDC guidelines suggest the standard sub-cut dose over the new fractioned intradermal method for anyone with a history of keloid scarring. Reading between the lines, my tentative assumption is that a different location for intradermal is difficult to negotiate. I don’t know how easy it is to manoeuvre the preference of dose-specific format at point of care, or perhaps with a prescription. The risk then must be similarly considered for a 2nd intradermal. Might be simpler to fly in and out of Canada for the standard method, a decision also based on your interpretation of what might be better immunologically and as someone with childhood VARV vaccination. Whichever way, in particular for intradermal, make sure the vial has been swirled for homogeneity of doses extracted.

Also your infection risk. I would probably roll up my sleeve now for the initial standard dose, if I hadn’t already a few months back, just because of the guidance, but I wonder if case incidence is naturally self-limiting and how much is attributable to vaccination campaigns. A dip in incidence is seen in Canada with about 20% of the target population having received at least one standard MVA-BN dose. A very substantial dip in case incidence in Spain is seen with merely 15,000 doses that reached only about 5% of the target population.

Edited September 7, 2022 by SirBillybob

[Dartaskan]

I received my first Jynneos vaccine on August 3rd. It was the full sized dose to the back of the arm. I had a small bump and a larger area of redness that resolved in about a week. Kind of hard to say for sure as I wasn't looking at it in the mirror since it really didn't bother me.

I got the second shot on September 1 and it was the new 1/5 dosing method. It was quite red, itchy and sometimes painful in the 72 hours after. It's significantly smaller now. It almost looks more like a bug bite that I scratched a bit more than I should have. It might also stand out a bit more on my skin since I'm fair-skinned and a redhead.

I was not given a choice as to where I got the shot, only a choice of left or right forearm. Since they inject a quantity of serum in such a way as to make a bubble under the skin, and for the dose to sit in the area for a while, it's why they don't want to just give you a shot in your shoulder. The nurse didn't mention there being a scar from this method. She did tell me that they wouldn't be using a bandage and not to use one myself as it would "suck the vaccine right out of my arm." So also not being covered could also make the healing take a bit longer.

I was born in 1972 and never received a smallpox vaccination. In 2002, I did a smallpox vaccine study to see if the old vaccine that was stockpiled in the US would work. They also tested us with different dilutions of the serum to see if they could make the vaccine on hand stretch further. When they administered that they made a bunch of scratches and pokes in a small area on my shoulder. That did leave a scar. It actually looks a bit different than a lot of the ones you see on older folks or those raised in other countries. The study had us keep our wounds covered for a period of time so we wouldn't cross contaminate anyone in our social groups. (Living without children and immune compromised individuals wasn't allowed.) For all this, I got $300.

The first consent form I did on August 3rd asked about prior smallpox vaccination. I indicated the study. The staff at the county health department said they weren't considering prior smallpox vaccination as it was decided it didn't matter. When I did the paperwork for the second shot, the question had been removed.

If it matters, this was Maricopa County, Arizona (Phoenix)

[Bacon]

For what it’s worth, I’ve personally observed four intradermall injection sites (including mine). All seem to have resolved without scarring. Actually, all progressed similarly too with a red itchy welt. Disappeared over the course of about three weeks.

[rvwnsd]

I received the first shot in my forearm on September 1. A week later, it looks like a mosquito bite - slightly raised red welt. The nurse mentioned it might itch (like a mosquito bite) but it doesn't. It is just red.