Monkeypox vaccine Q&A: Who is eligible now and why

7/28/22 – For our latest update on vaccination, please see this blog posted 7/27/202

Update on vaccine distribution: 7/22/2022

Monkeypox cases are on the rise in King County and our region will need a substantial increase in vaccine supply to reach everyone potentially at risk. We understand why people are concerned right now, and we expect to receive more information soon on our next allocation of vaccine.

Public Health has received our initial allocation of vaccine — 1420 doses, and are distributing doses now.

Our focus with these limited doses is to get them to health care providers to vaccinate people at high risk of recent exposure to monkeypox—including men who have sex with men who have had recent multiple sexual or intimate close contact partners. This approach aims to help slow the spread of the disease, particularly for people who may have been exposed but may not have symptoms yet.

These providers, such as the Public Health Sexual Health Clinic at Harborview, routinely provide sexual health services to men who have sex with men and have a large proportion of patients who are uninsured/underinsured and people of color. We know that first-come, first serve strategies may not always reach those at higher risk, so Public Health is working to balance multiple approaches.

Contact your healthcare provider immediately if you think you have been exposed or have symptoms. If you develop symptoms, avoid sex or other close intimate contact and make sure any rash is covered until you have been evaluated.

We will continue to provide updates about monkeypox and vaccine at our monkeypox website

Original post: 7/13/22

With the news of monkeypox transmission in our community, we’ve heard very important questions from our community about access to monkeypox vaccine and who is eligible for vaccine now. From our team at Public Health, here are a few of your questions and what we know now.

How many doses of vaccine is King County receiving and who is eligible now for these vaccines?

Initially, we will be receiving up to 710 courses of vaccine (1,420 doses) from CDC. With this extremely limited supply, we are reserving these doses primarily for people who are close contacts of someone with known monkeypox and with high and intermediate risk of exposure. Vaccination for these individuals may prevent close contacts from getting monkeypox or may reduce the severity of their illness.

The national supply of vaccine for monkeypox is currently limited, although more is expected later in the summer and into the fall.  The CDC is sending the vaccine to areas with a high number of cases. King County has relatively few cases compared with other areas at this time. Therefore, we are currently not prioritized to receive a large number of doses of vaccine.

I’ve heard about places like New York that are offering vaccination clinics and people can sign up to receive vaccine. Is King County offering vaccine in a similar way?

Some places like New York have received more vaccine from CDC in this first phase based on their case numbers. We have heard from Washington State Department of Health and CDC that they anticipate a second allocation of vaccine later in July. So currently, we don’t have vaccine beyond the initial courses to be able to vaccinate a larger group of higher risk individuals.

We are starting to work with the healthcare community and community partners to plan for when more vaccine may be allocated to us later in the summer and into the fall.

Can Public Health – Seattle & King County ask for more doses from CDC?

Criteria for receiving vaccine is set by CDC, and not by local health departments. That said, we have been in contact with Washington State Department of Health and receive updates from CDC so that we can learn about their distribution plans as they are developed and start our planning. We expect to hear in the coming weeks about how much vaccine will be allocated to the state and to our county.

Who is likely to be eligible for vaccine when more becomes available?

When we receive more vaccine, our aim will be to provide access initially to those at highest risk for exposure to monkeypox. The infection is transmitted by close and intimate contact, including skin-to-skin and sexual contact. For example, some locations that have received more vaccine, internationally and in the U.S., have prioritized people who recently have had multiple sex partners, participate in anonymous sex, or attend “sex on premises” venues.

We also recognize that each city and county is unique, and we are starting our planning now by reaching out to community organizations and healthcare providers that work closely with people at highest risk to help inform our approach. Front and center will be planning to address barriers driven by factors such as insurance status, geography, structural racism, socio-economic status, language, and access to care.

How concerned should I be if I’m at higher risk?

We recognize that people may have different levels of concern about monkeypox. Given this is the “Public Health Insider,” we want to give you a sense of our level of concern.

Based on what we know now (and noting this is a newer outbreak and we can’t predict where things are headed), our disease experts and epidemiologists are concerned, but not panicked. On one hand, it’s very good news that there haven’t been deaths due to the virus and very few hospitalizations. Most people will recover after a few weeks, and monkeypox is not likely to lead to long-term health consequences.

On the other hand, the rash can be painful and other flu-like symptoms can be very uncomfortable. Isolating while contagious can also be challenging. The virus can spread throughout sexual networks and can have more severe impacts for some people, such as those who are immunocompromised.

We are also concerned because there have been over 10,000 cases in 59 countries that have historically not reported monkeypox, and many countries are reporting a significant number of cases without links to known cases, indicating undetected transmission. We also don’t know at this point how long the outbreak will last, or if this outbreak will be short-term, will last for several months, or if monkeypox will become a circulating, ongoing virus that will require a much larger vaccination strategy to control. A larger vaccine strategy would require increased production of vaccine and another large-scale public health response from a public health system already strained by the COVID response.

The bottom line is that we never want a contagious, infectious disease to be circulating in our community, and are responding by working to identify people who have been exposed or might be at risk of exposure and sharing information that can help people reduce spread of the virus now, while vaccine supply is very limited.

If more vaccine will take some time to arrive in our community, what can those at higher risk do now to help prevent spread and protect themselves?

A person’s risk for monkeypox is determined by their behavior and the people, or network of people, they come into physical contact with.  To date, all of the patients diagnosed with monkeypox in King County have been among men who reported sexual or close intimate contact with other men, sometimes with anonymous or multiple partners. Anyone who has high risk contact with a person who has monkeypox can be infected, regardless of sexual orientation or gender identity.

If you or your partners feel sick or have any rashes or sores, avoid sex and gatherings, especially if they involve close skin-to-skin contact or prolonged face-to-face contact, and see a healthcare provider to get checked out. This is always a good plan, even if a rash or illness is not related to monkeypox.

Considerations for reducing risk and preventing spread

Monkeypox is spreading and is on the rise in our community. Here are some things people can consider to decrease their risk for monkeypox:

  • Decreasing number of sex and intimate contact partners.
  • Not going to places like bathhouses or other public sex venues.  
  • Avoiding raves, parties, or clubs where people wear minimal clothing and where there is direct, intimate, skin-to-skin contact. For those who attend these events or venues, avoid coming into contact with rashes or sores you see on others and minimize skin-to-skin contact when possible.
  • Events where attendees are fully clothed and unlikely to share skin-to-skin contact are safer. However, attendees should be mindful of activities (like kissing) that might spread monkeypox.

As this is a newer outbreak, public health entities nationally and internationally are still learning about the behaviors that may put people at increased risk and we will continue to share information with the community as we learn more. Check for updated case counts in King County and the latest information.

Originally posted on 7/13/22