Kelli Hawkins, SRHD | khawkins@srhd.org | 509.324.1539, c 509.994.8968

Limited vaccine supply calls for proactive strategy

Spokane, Wash. – Although no cases have yet been confirmed in Spokane County, Spokane Regional Health District (SRHD) is currently reaching out to individuals identified as high risk for exposure to the monkeypox virus and offering a dose of the JYNNEOS^™ vaccine as an option to help slow the possible spread of the virus locally before an outbreak takes place.

As of July 26, 2022, 101 people in Washington state have tested positive for monkeypox, including one person who was exposed in another state, but tested positive in Washington.

“Taking a proactive approach will help contain future outbreaks and is necessary due to the limited amount of vaccine available in the United States,” said Spokane County Health Officer Dr. Francisco Velázquez.

SRHD has prioritized high-risk individuals during this time of vaccine shortage based on the following criteria and will work with medical providers to identify and offer the vaccine. The criteria includes:

• Those at high risk of a recent exposure to monkeypox, including members of the gay, bisexual, transgender, and gender non-conforming community and other communities of men who have sex with men and who have engaged in intimate, or skin-to-skin contact with others in the past 14 days in areas where monkeypox is spreading.
• Individuals who have had skin-to-skin contact with someone in a social network experiencing monkeypox activity, including men who have sex with men who meet partners through an online website, digital application ("app"), or social event, such as a bar or party.
• Individuals with recent monkeypox exposure are also eligible for post-exposure prophylaxis. These close contacts as identified through SRHD case investigations will be given direction on how to access monkeypox vaccine.
• Individuals with specific medical histories that may affect the immune system or that indicates participation in high-risk activities.

SRHD received 320 doses of the JYNNEOS^™ vaccine from the Washington State Department of Health’s (DOH) allotment of several hundred total. DOH is requesting that each jurisdiction receiving an allocation hold 25% of their allocation for prepositioning of vaccine around the state. This portion of the allocation may be requested by DOH for neighboring LHJs and/or tribal partners. Washington expects to receive a larger supply of vaccine in late August. How the vaccine will be divided up, and who in Washington will receive it, will depend on how much vaccine the state receives and where cases are located.

In addition to a targeted approach to administering the vaccine, SRHD will prioritize first doses at this time, a distribution strategy currently taken in New York City, the UK and Canada where cases are rapidly increasing.

This decision is based on the available scientific evidence, the accelerating outbreak, the high number of eligible people and demand for vaccine, and extreme shortages of JYNNEOS^™ vaccine nationally. In many instances, this means that individuals may not get a second dose by the 28-day interval between doses as is indicated in the Food and Drug Administration (FDA) prescribing label. Despite the delay, this should not affect the immune response to the second dose.

“At this time, we have enough vaccine to begin to offer vaccine to all high-risk people,” Velázquez said. “We will use less than half of the current vaccine on hand for this approach, while keeping most doses on hand for close contacts in eventual outbreaks locally and in neighboring health jurisdictions.”

SRHD health officials will continue to advocate for more supply of the Federal allotment through DOH. Second dose appointments will be scheduled once there is enough vaccine to do so.

“While the threat of monkeypox generally remains low, it’s important that everyone be aware of this disease, so that those at risk can seek medical care and get tested promptly if they believe they have symptoms,” said Velázquez.

In addition to implementing a vaccination strategy, SRHD has been working with health care providers and community partners over the last two months to promote awareness of monkeypox, including what symptoms to look for, how to test for it, and ways to help prevent transmission.

Symptoms of monkeypox can include fever, headache, muscle aches, swollen lymph nodes, and a rash that can look like pimples or blisters. In this outbreak, some individuals have had a rash only and no other symptoms, and sometimes the rash consists of only a few sores. The rash can occur in the mouth, and there may be sores in the genital and anal areas. In other cases, a rash may be on the face and on other parts of the body.

The illness typically lasts two to four weeks and most people get better on their own without treatment. However, sometimes monkeypox can cause scars from the sores, lead to pneumonia, and in rare cases even be fatal. People who have monkeypox can spread the virus from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed.

To prevent the spread of monkeypox:

• Practice good hand hygiene by washing your hands with soap and water or using an alcohol-based hand sanitizer
• Minimize skin-to-skin contact with individuals who have been exposed to the virus or to those showing a rash or skin sores
• Avoid contact with any materials, such as clothing or bedding, that has been in direct contact with someone with monkeypox
• Reach out to a health care provider if you develop symptoms, as early recognition and testing can help prevent further transmission

More information about the virus and how to limit infection risk can be found on the monkeypox page on SRHD’s website. The current status of Washington state’s monkeypox outbreak and further information on vaccine distribution can be found on DOH’s website.