The Biden Administration announced on Tuesday a nationwide vaccine strategy to control the spread of the monkeypox virus in the United States as cases continue to increase.
So far, there have been 306 confirmed cases of monkeypox identified across 28 states, according to the Centers for Disease Control and Prevention (CDC).
The U.S. Department of Health and Human Services (HHS) will make 296,000 doses available in the coming weeks with 56,000 of those doses made available immediately to areas with high monkeypox transmission.
HHS will begin by prioritizing states with the highest case rates of monkeypox, which include California (66 cases), New York (63 cases), Illinois (45 cases), Florida (27 cases), and Washington, D.C. (20 cases).
Other states with confirmed cases will also be able to order/request vaccines using a tiered allocation system.
"The administration’s current strategy is focused on containing the outbreak by providing vaccines to those most in need to prevent further spread of monkeypox in the communities most impacted," Rochelle Walensky, MD, MPH, the Director of the CDC, told reporters during a media briefing Tuesday. "As additional supply becomes available, we will further expand our efforts, making vaccines available to a wider population."
Cities like New York and Washington, D.C. were among the first to begin vaccinating at-risk groups for monkeypox, however, appointments ran out quickly with no more appointments available at the moment.
Monkeypox is a rare disease related to smallpox defined by raised lesions on the skin. It is spread through close contact with an infected person’s rash, bodily fluids, or respiratory secretions.
The vaccine being distributed is the JYNNEOS vaccine, which is administered in two doses and delivered 28 days apart. People who receive the vaccine are not considered vaccinated until two weeks after they receive the second dose of the vaccine, Teena Chopra, MD, MPH, professor of medicine, division of infectious diseases at Wayne State University, told Verywell.
HHS expects an additional 240,000 doses to be shipped out over the next few weeks with thousands of more doses to come this summer and fall. All told, officials anticipate making at least 1.6 million monkeypox doses available in the U.S. by the end of the year.
Despite the ramp up in production, health experts worry the limited supply now will not be sufficient enough to stop or significantly slow the spread of the virus.
“The supply of vaccine is limited at this point, and to prevent transmission, vaccination should be given as early as possible after exposure,” Robert Bollinger, MD, MPH, professor of infectious diseases and professor of medicine at Johns Hopkins Medicine, told Verywell. “The hope is that vaccination of exposed persons could reduce the spread of the infection. We will have to see if this current effort is sufficient to slow down transmission.”
The updated White House monkeypox outbreak response plan recommends people with confirmed and presumed monkeypox exposure receive the JYNNEOS vaccine.
Initially, the only people who could get monkeypox vaccines were those with a confirmed exposure. But due to the difficulty identifying close contacts during the current outbreak, the new plan states contact tracing or confirmed exposure are not prerequisites for vaccination; if someone believes they've been exposed, that's enough.
"This expands the ring from known contacts to possible contacts," Richard Reithinger, PhD, vice president of global health at research nonprofit RTI International, told Verywell. "If people have been at an event where monkeypox is known to have spread, they are now eligible for vaccination."
According to the White House, eligible groups include:
Reithinger said a booster may be necessary every 10 years.
He noted that an older smallpox vaccine called ACAM2000 is also available, but that vaccine is considered to have a greater risk of side effects and is not recommended for people who have HIV.
While the U.S. is expanding the availability and number of monkeypox vaccines over the course of the year, Chopra said more vaccines are needed quickly so that they are accessible to all states, not just the ones where case numbers are high.
"We also need to make sure we recognize the illness early on and offer vaccines to high-risk individuals," she added.
Reithinger said that the virus is easy to recognize. Monkeypox symptoms like rashes and lesions are quite visible and only symptomatic individuals are infectious. You'll know if you have it and if you can spread it.
Therefore, Reithinger said mass testing is not a recommended or effective approach. Diagnostic testing is only recommended to confirm clinically suspected cases.
Since there have been about 300 cases of monkeypox and no deaths in the U.S., the risk to the American public is still considered low. The main transmission route requires person-to-person contact, Reithinger said—it's not currently believed to spread through airborne particles like COVID-19 can be.
To effectively mitigate the human-to-human spread of monkeypox, Reithinger said important public health measures include:
Monkeypox is typically spread person-to-person through sex, kissing, and being in close contact with someone else who has the virus, Chopra said.
"Even though a large number of cases have been in gay/bisexual men, it can spread to anyone through close contact and through the respiratory route," Chopra added. "People can also catch the virus through contact with contaminated bedding."
According to the CDC, there can be multiple degrees of exposure. You can be exposed to monkeypox in several ways:
Pregnant people can also spread the virus to their fetuses through the placenta.
It is also possible to get monkeypox from infected animals if you are bitten or scratched, though that's not what's causing the current outbreak.
To prevent getting monkeypox or to minimize exposure to the disease, people should try to avoid locations where clusters of monkeypox have been reported, Reithinger said.
Other prevention measures include:
If you are showing any symptoms of monkeypox, Reithinger recommends contacting your healthcare provider for next steps, including for confirmatory testing and follow-up medical care. If possible, people with confirmed or probable exposure should isolate themselves for at least 14 days and avoid close contact with other people.
"For contacts of confirmed cases, vaccination is recommended, ideally within four days of first exposure, and up to 14 days in the absence of symptoms," Reithinger said. "This can prevent the onset of disease or reduce severity of symptoms."
More doses of the monkeypox vaccine will soon be available in the coming weeks across different states in the U.S. If you had close contact or probable exposure to someone with monkeypox, you are eligible for the JYNNEOS monkeypox vaccine.