The UK Health Security Agency (UKHSA) has announced that second doses of the smallpox (Jynneos) vaccine will be offered to people at highest risk from monkeypox, in order to maximise protection against the virus.

This targeted approach is also supported by modelling published in today’s technical briefing 8 which suggests vaccinating 25% of the groups most at risk could significantly reduce the risk of transmission.

Whilst sexual health clinics will continue to prioritise offering first doses to those at highest risk, some clinics will also begin to offer eligible people a second dose to provide longer term protection.

The Joint Committee on Vaccination and Immunisation (JCVI) has endorsed UKHSA’s proposal to offer second doses to those at highest risk, while continuing efforts to maximise uptake of the first dose within this group.

There are no current plans to widen the offer of vaccination beyond the existing priority cohorts, though this decision will be kept under review.

The NHS will call forward those that are eligible for vaccination. Second doses will be offered from around 2 to 3 months after the first dose to maximise protection.

As of 20 September, more than 45,000 people have received a dose of the vaccine including over 40,000 gay, bisexual and other men who have sex with men who are at highest risk of exposure.

In order to maximise the number of people that can be vaccinated, more clinics will offer the vaccine using intradermal administration in the coming weeks. This safe and clinically approved approach has been positively received by patients and staff where it has been used already.

UKHSA has confirmed delivery of 20,000 additional vaccines from Bavarian Nordic, the single global supplier of the vaccine being used in response to the current outbreak of monkeypox in the UK. The vaccines are available for NHS services to order and are being distributed now, with a further 80,000 vaccines expected to arrive later this month.  The use of intradermal administration will mean that everyone at highest risk will have access to two doses of monkeypox vaccine in the coming months.

As of 16 September, there are 3,585 confirmed and highly probable cases of monkeypox in the UK. Following a clear peak of more than 60 cases per day in mid-July, the number of cases has decreased throughout August and continues to fall, with less than 15 cases per day on average in early September.

Analysis of wider infection trends suggests changes in behaviour in the groups most at risk may have contributed to the reduced case rates.

Dr Gayatri Amirthalingam, Deputy Director, Public Health Programmes at UKHSA said:

It’s encouraging that we’re continuing to see fewer cases of monkeypox reported in the UK and we are grateful to everyone who has followed advice about potential symptoms, isolated as part of this outbreak or come forward for a vaccination to help limit transmission.

Prioritising vaccine stock where possible for second doses for those at highest risk will help us maximise protection and interrupt transmission. When you are called forward for vaccination, please take up the offer.

Professor Sir Andrew Pollard, chair of the JCVI, said:

The JCVI has endorsed the UKHSA’s proposal that vaccination to protect against monkeypox should continue to be prioritised for those at highest risk of exposure to the virus, including offering second doses to individuals once they become eligible.

This approach will ensure the globally-limited supplies are used most effectively, continuing to break chains of transmission, as well as providing those at highest risk of exposure with longer-lasting protection.

The use of the intradermal vaccination method at some clinics also means more doses can be drawn from the vials, helping to maximise the reach of the UK’s supplies and ensure second doses for all those eligible. The JCVI will keep the offer of monkeypox vaccination under review to ensure it continues to have the maximum impact on the current outbreak.

I am sincerely grateful to Norway for bringing us together and to the Government of Israel and Palestinian Authority for their participation.

Let me begin by expressing our deep concern over the grave economic situation in the Occupied Palestinian Territories.

If we are to achieve peace and stability in the region, it is of course vital that the Palestinian Authority and UNWRA are on a stable financial footing.

The United Kingdom is committed to supporting this.

We will continue to work directly with both parties to help boost economic development, trade and investment.

This includes offering technical assistance to the Palestinian Authority and supporting Palestinian companies to boost exports, among other things.

We were pleased to hear about the success of the E-VAT pilot and welcome Israel’s commitment to rolling out the system to all Israeli businesses.

As we know, this has the potential to raise more than $100 million per year for the Palestinian Authority.

It is a clear signal of the value of cooperation between the parties and the donor community.

We also welcome the Government of Israel’s efforts to enable electronic payments to Palestinians working in Israel.

And we are glad to see the positive steps taken by the Palestinian Authority, as outlined by Finance Minister Bishara, to reduce the public sector wage bill.

Madame Chair,

While we welcome commitments made by the parties and the spirit of cooperation they bring today, progress has not been as fast as we would have liked.

We need much quicker progress on fiscal reforms, and efforts to reduce barriers to trade and investment in the West Bank, if we stand any hope of reviving economic growth in the Occupied Palestinian Territories.

We call on the Government of Israel to undertake reforms to the clearance revenue mechanism and to renew efforts to tackle the restrictions and costs facing Palestinian businesses.

We would also like Israel to take a decision on the handling fee on Palestinian Authority fuel purchases – which is disproportionate, in our view.

We urge the Palestinian Authority to bolster work with partners, including the International Monetary Fund, on the reforms necessary to address the fiscal crisis and build a more stable future.

We must also retain focus on the humanitarian situation in Gaza and the need for economic recovery and reconstruction.

Only last month, we saw yet another escalation of violence on the strip.

We welcome the increase in permits for Gazans to work in Israel but unemployment remains unacceptably high.

We urge Israel to continue increasing work permits and reducing restrictions in order to create more jobs.

Madame Chair,

There is no hope of making progress on these issues without ministerial level engagement and dialogue, and we would like to see this stepped up.

We welcome the parties’ commitments to re-establishing the Joint Economic Committee as the key body for decision-making, and call for this meeting to take place urgently.

The UK will do all we can to support the parties to work together to address challenges and strengthen Palestinian Authority institutions for the future.

Madame Chair,

While we have rightly focussed on the economic situation today, I must also address the bigger picture. We are gravely concerned about the deteriorating security situation in the West Bank and the risk of instability.

The UK calls on both parties to refrain from taking actions that undermine the prospect for peace.

This includes all unilateral and provocative acts, and breaches of international law.

These take us further from a negotiated two-state solution, and the long-term peace and stability that Israelis and Palestinians so deserve.

The UK will do all we can to support progress towards that goal.