The number of confirmed monkeypox infections in King County is doubling each week, and health officials say the county has only about 6% of the vaccine supply needed to provide two-dose shots to those considered at high or elevated risk for the disease.

“I think it is important to realize while we have more vaccine that will be available in the relatively near future, we do not currently have an adequate supply,” Dr. Matthew Golden, director of Public Health – Seattle & King County’s HIV/STD Program and Sexual Health Clinic, said at a Thursday briefing.

In Washington, 104 people have tested positive for orthopoxvirus as of Wednesday; all orthopoxvirus cases are likely monkeypox, according to the Washington State Department of Health. This includes one person who was exposed outside Washington but tested positive here.

Ninety-two of the cases have been 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 health department said.

As of Wednesday, all cases have been among men who had sexual or close intimate contact with other men, according to Public Health – Seattle & King County. 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.

The health department said it has identified at least 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 people in those groups. The health department has received 4,720 doses.

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What to know about monkeypox

The health department received an initial shipment of 1,420 vaccine doses on July 22 and distributed them to eight sites. It received a second shipment of 3,300 doses Wednesday. The county plans to use one-third in its sexual health clinic, distribute one-third to clinical providers and use the remaining third in community vaccine events that officials hope to have up and running in approximately 10 days, Golden said.

The JYNNEOS vaccine of two doses that is meant to be administered four weeks apart is not recommended for the general public. Doses are being prioritized for people who have had close intimate contact with someone who tested positive for monkeypox or are at high risk of exposure to monkeypox.

The health department defines the priority group as gay, bisexual or other men or transgender people who have sex with men and meet one of the following criteria: had more than 10 sex partners in the past three months, have a history of early syphilis or gonorrhea in the past year, used methamphetamine in the past month, attended a bathhouse or other public sex venue or had group sex in the past three months, or experienced homelessness/unstable housing and currently lives in a congregate setting and had any sexual activity in the past three months.

King County’s eligibility differs from other cities. In New York City, for example, adult gay or bisexual men or other men who have sex with men, and/or transgender, gender nonconforming or gender-nonbinary people are eligible if they have had multiple or anonymous sex partners in the past two weeks. In Vancouver, B.C., eligibility includes having had two or more sexual partners, or casual sex, within the last 21 days.

Some Seattle residents, frustrated with limited supply in the area, have traveled to Vancouver for vaccines. Golden called the reported travels a reasonable thing to do and said he admired that the Canadians were sufficiently prepared.

Golden said the health department is trying to be more targeted in its distribution of doses but expects that to change as more vaccine comes in. The U.S. Department of Health and Human Services Thursday announced allocation plans for an additional 786,000 JYNNEOS doses, though it’s unclear how many will go to Washington state.

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He echoed a recommendation earlier this week from the World Health Organization urging those in the high-risk group to consider decreasing their number of sexual or intimate partners in the short- to mid-term.

“This is not a request to have people change who they are, we are not asking people to change their life forever, we are not interested in judging anyone and we are not interested in telling people how to live their lives,” Golden said. “But we do want to give people information that can promote their health and help keep our community safe.”

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