Monkeypox cases are doubling nearly every week in Washington, concerning state health officials as the vaccine supply runs short and the U.S. declares a public health emergency over the outbreak.
In Washington, 166 people have tested positive for orthopoxvirus as of Thursday; all orthopoxvirus cases are likely monkeypox, state Secretary of Health Dr. Umair A. Shah said during a news briefing Thursday. This includes at least two people who were exposed outside Washington but tested positive here.
About 144 of the cases were reported in King County, the state’s most populous. A majority of the people who tested positive in King County live in Central Seattle, the state Department of Health has said.
In addition, there have been seven cases confirmed in Pierce County, three in Clark County and two in Snohomish and Kitsap counties.
As of Thursday, the majority of cases were among men who had sexual or close intimate contact with other men, Shah said. Across the U.S., infections also have been concentrated among men who have sex with men, though that hasn’t been true in other outbreaks abroad. Health officials stress that anyone can contract monkeypox.
“This is a human disease and is not limited to any community,” Shah said Thursday. “And when we do stigmatize people, those individuals often do not feel comfortable seeking care.”
In Washington, state health officials have ordered and distributed about 6,800 doses of the JYNNEOS vaccine, which has been approved by the U.S. Food and Drug Administration for prevention of smallpox and monkeypox in adults. The number reflects about 96 percent of the state’s first two rounds of federal allocation, said Michele Roberts, DOH’s assistant secretary for prevention & health.
The state has also been allocated more than 17,000 doses of additional vaccine, which will be sent over in three phases in the next four to six weeks, Roberts said.
She noted the state is adopting a “first-dose prioritization” strategy, which means recipients will initially get only one shot of the two-dose vaccine in an attempt to stretch supply for as many high-risk people as possible.
Still, there aren’t enough doses for everyone at high risk, she said, so vaccine eligibility remains limited to those with confirmed monkeypox infections or direct exposures.
“We do not have enough vaccine to open up broadly to the whole LGBTQ+ community or to those at highest risk at this point,” Roberts said. “As more vaccine becomes available, we’ll be opening up more broadly.”
In King County, public health teams have received only about 6 percent of the vaccine supply needed to provide two-dose shots to those considered at high or elevated risk for the disease, Dr. Matthew Golden, director of Public Health — Seattle & King County’s HIV/STD Program and Sexual Health Clinic, said last week.
Of the state’s roughly 6,800 vaccine doses received to date, King County has received about 4,720 vaccine doses to cover the 20,000 people considered at highest risk for monkeypox, and 20,000 more at an elevated risk. Ideally, Golden said, there would be 80,000 vaccine doses — two per person — to cover the 40,000 King County residents in those groups.
Statewide, about 96 percent of vaccines allocated by the federal government have been ordered and distributed, the health department said. While the state is working to estimate how many people statewide are considered high-risk for monkeypox, no specific numbers were available Thursday, said Dr. Tao Sheng Kwan-Gett, the state’s chief science officer.
The slim supply of monkeypox vaccine in King County and Washington state comes from a federal shortage of doses, local health officials have said. The delay is due in part to failure by the U.S. Department of Health and Human Services to ask early on that its bulk stocks be bottled for distribution, The New York Times reported this week.
By the time the federal government did place its orders, the vaccine’s Denmark-based manufacturer had already booked other clients and was unable to do the work for months, The Times reported.
Now the federal government is distributing about 1.1 million doses, but most of the other 5.5 million doses it ordered are not scheduled to be delivered until next year.
The federal government’s decision to declare a public health emergency will free up federal funding and resources to fight the virus.
Kwan-Gett on Thursday reminded the public the illness from the virus often begins with flu-like symptoms before a sometimes painful rash emerges. It’s common for rashes to look like little red bumps that become fluid-filled, then eventually turn into scabs and fall off, he said.
Transmission is most common through skin-to-skin contact, though the virus can also spread through prolonged face-to-face contact and contact with infected fabrics, like clothes or sheets, he said.