Monkeypox cases are doubling in Washington, according to state health officials, as vaccine shortages prompt the US to declare a public health emergency over the outbreak.
As of Thursday, 166 people in Washington have tested positive for orthopoxvirus; All cases of orthopoxvirus are likely to be monkeypox, said Health Secretary Dr. Umair A. Shah said during a briefing on Thursday. That includes at least two people who were outside of Washington but tested positive here.
About 144 cases have been reported in King County, the state’s most populous. Most of the people who tested positive in King County live in Central Seattle, according to the state Department of Health.
In addition, seven cases were confirmed in Pierce County, three in Clark County and two each in Snohomish and Kitsap counties.
As of Thursday, most of the cases were among men who had sexual or intimate contact with other men, Shah said. In the US, infections are also concentrated among men who have sex with men, but this has not been the case in other outbreaks abroad. Health officials stress that anyone can be infected with monkeypox.
“This is a human disease and not limited to any community,” Shah said on Thursday. “And when we stigmatize people, those people often feel uncomfortable seeking care.”
In Washington, state health officials ordered and distributed 6,800 doses of JYNNEOS, a vaccine approved by the US Food and Drug Administration to prevent smallpox and monkeypox in adults. The count represents about 96% of the state’s first two rounds of federal allocations, said Michelle Roberts, DOH assistant director of prevention and health.
The state has also been allocated more than 17,000 additional doses of vaccine, which will be shipped in three phases over the next four to six weeks, Roberts said.
He noted that the state is adopting a “first-dose priority” strategy, which means recipients will first receive only one shot of the two-dose vaccine, in an effort to expand coverage to as many at-risk individuals as possible.
Still, there aren’t enough doses for everyone at high risk, he said, so the vaccine is limited to people with confirmed or direct exposure to monkeypox.
“We don’t have a vaccine that will be widely available to the entire LGBTQ+ community or to those who are most at risk at this point,” Roberts said. “Once more vaccine is available, we will open more widely.”
In King County, public health teams received only 6% of the vaccine needed to give two-dose injections to those considered to be at high or high risk of the disease, said Dr. Matthew Golden, director of Public Health – Seattle and King County’s HIV/STD program and sexual health clinic, said last week.
Of the approximately 6,800 vaccine doses received in the state to date, King County has received 20,000 doses of the vaccine for those considered to be at highest risk of monkeypox and another 20,000 for those considered to be at high 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.
According to the Department of Health, about 96% of the vaccines allocated by the federal government across the state have been ordered and distributed. While the state works to estimate how many people statewide are at risk of contracting monkeypox, no specific numbers were available Thursday, Dr. Tao Sheng Kwan-Gett, Chief Scientific Officer of the State.
The low supply of monkeypox vaccine in King County and Washington state is due to a shortage of federal doses, local health officials said. The delay is due in part to the U.S. Department of Health and Human Services not requesting that its essential supplies be bottled for distribution, The New York Times reported this week.
At the time the federal government issued its order, the Denmark-based vaccine manufacturer had ordered other customers and was unable to make the case for months, The Times reported.
The federal government is now distributing about 1.1 million doses, but most of the remaining 5.5 million doses it has ordered will not 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.
On Thursday, Kwan-Gett begins a public illness from a virus, often with flu-like symptoms and sometimes a painful rash. The rash usually looks like small red bumps filled with fluid that eventually scab over and fall off, he said.
Transmission is usually through skin-to-skin contact, but the virus can be transmitted through prolonged face-to-face contact and contact with infected fabrics such as clothing or bedding, he said.