Five Questions With: Dr. Amy Nunn

Dr. Amy Nunn is executive director of the Rhode Island Public Health Institute, which operates Open Door Health, a health clinic that offers primary and sexual health care for the LGBTQ+ community. The clinic is offering appointments for monkeypox vaccinations, and is starting a wait list for eligible Rhode Islanders to receive vaccines as they become available. 

Nunn discusses Rhode Island’s vaccination efforts, what’s known so far about the vaccine and symptoms of the disease. 

PBN: Is there current data on how many monkeypox cases have been confirmed in Rhode Island? 

NUNN: As of Aug. 5, there have been a total of 28 monkeypox cases confirmed in Rhode Island and over 7,000 confirmed cases nationwide, according to the Centers for Disease Control and Prevention. While that number may seem low to some, we are still learning more about the virus itself, and – because testing and surveillance efforts are still ramping up – it’s very possible the number of confirmed cases underestimates the total number of people who have contracted the virus. We are at the early stages of the epidemic, and it’s important that we act now to help stop the spread of monkeypox.

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PBN: How many doses of the vaccine are available now through Open Door Health, and when do you expect to have more? 

NUNN: It’s difficult to accurately provide an exact, real-time number of doses available, as we are vaccinating many people every single day. What we can say is that vaccine supply remains extremely limited across the country. Distribution of the Jynneos vaccine is being handled by the federal government, and Open Door Health is working with the R.I. Department of Health to secure and administer doses as they become available. This past week, RIDOH announced it had received additional doses of the vaccine, many of which were distributed to eligible Rhode Islanders during two successful community vaccine events held on Friday, Aug. 5, and Saturday, Aug. 6.

As of this writing, Open Door Health is accepting vaccination appointment requests from any gay, bisexual or other man who has sex with men and reports multiple sexual partners. We ask that eligible individuals register at Our clinical team is administering shots immediately as they become available, and starting a waiting list for eligible Rhode Islanders. This program will allow us to efficiently serve our patients as the national vaccine supply increases.

PBN: What was the response after the R.I. Department of Health announced its vaccine clinics on Aug. 5 and 6? 

NUNN: The response was overwhelmingly positive. There’s no question the demand for these vaccines is high, and we remain hopeful that the national supply will catch up to that demand soon. We’re urging our patients and other at-risk Rhode Islanders to speak with their care providers, practice caution, and – if they are presenting symptoms – to make an appointment to get tested as soon as possible.

In the meantime, Open Door Health is doing its best stay in touch with our community and continue our effort to provide care in an affirming, welcoming and inclusive environment. This virus, still in its early stages, has already become somewhat stigmatized because it has been associated with sexual transmission. As the state and the country continue the effort to address this virus, we’re calling on Rhode Islanders to collectively reject that stigma and treat people with the dignity and respect they deserve.

PBN: Can you tell us what’s known so far about the monkeypox vaccine? Will patients need just the two-dose series, or is it expected that people at high risk may need a booster or even an annual vaccination?

NUNN: There is still limited scientific data about monkeypox vaccination in general. This includes exactly how effective the vaccine is, how long immunity will last and how quickly vaccination can stop monkeypox spread. Again, we’re still learning, but we know the monkeypox virus comes from the same family as the virus that causes smallpox. We also know that the virus can spread through direct, often skin-to-skin contact with monkeypox rashes, sores or scabs. It can also spread through direct contact with objects, fabrics and other surfaces that have been used by someone with monkeypox, and through respiratory droplets or oral fluids from a person with monkeypox.

While the virus is currently most commonly impacting men who have sex with men, we don’t yet understand why. This warrants further scientific investigation. Moreover, while current protocols call for two monkeypox shots, we don’t currently know whether boosters will be needed in the future. Monkeypox is in a different family than COVID-19, so we don’t expect as many mutations as we did with COVID-19. As a public health scientist who is also committed to public health action, I always encourage the public to be open to learning and adapting to new prevention measures as new scientific data emerges.

PBN: Once someone has been exposed to monkeypox, what is the incubation period before symptoms typically start, and what are some of the most common symptoms that patients in Rhode Island are reporting? 

NUNN: Symptoms, while typically much less severe and very rarely fatal, may include fever, headache, muscle aches, chills, and rashes that may look like pimples or blisters. Individuals should familiarize themselves with what monkeypox rashes look like, and get tested immediately if they are showing symptoms.

The incubation period, on average, is seven days – but it can be anywhere between four to 21 days. To reiterate, all of the data we have to date suggests monkeypox is rarely fatal. There have been no deaths due to monkeypox in the United States, and very few hospitalizations, many of which were due to pain from sores, bacterial infections, and sometimes inflammation of the kidneys or heart.

In some cases, monkeypox can lead to less-visible, atypical symptoms, such as rectal pain without a visible rash. Again, we urge Rhode Islanders to keep an eye on their symptoms and contact their medical providers with further questions.

Elizabeth Graham is a PBN contributing writer.