Pa. got more than 3,000 doses of monkeypox vaccine this week, but access is still limited

Pennsylvania received another 2,700 doses of monkeypox vaccine Friday, the state health department said, a sixfold increase in the available supply as cases rise locally in the widening national outbreak.

The department said it had a distribution plan that should get the shots to residents exposed to the virus in a matter of hours.

In Philadelphia, health officials have said a delivery of 225 vaccine doses earlier this week was not enough to contain the virus. The city has identified 17 cases, but many experts believe the reported numbers represent an undercount due to limited testing only now being alleviated.

City officials are expecting to receive more vaccines, but did not disclose how many.

The state continues to see a growing case count. As of Thursday, Pennsylvania reported 43 confirmed or probable monkeypox cases, according to the latest data from the Centers for Disease Control and Prevention, twice the number reported at the end of last week.

» READ MORE: Monkeypox vaccines coming to Philly, but health officials say it’s not enough

New Jersey reported 31 cases Friday.

More doses are urgently needed, said Dusty Latimer, a physician’s assistant at Philadelphia’s Mazzoni Center, which focuses on health care for people in the LGBTQ community. He gave 15 tests for the virus in just the past week, he said. The majority were positive.

Many of the current infections appear to date back to the Fourth of July weekend, said Latimer, who fears the number of cases “is going to skyrocket.”

Monkeypox causes lesions and rashes that can last for up to a month. While the virus has not caused death or severe illness, Latimer has been shocked by how much pain his patients experience. Some have the blemishes in their rectal or genital areas. A drug called tecovirimat can ease the symptoms, but it’s in short supply, he said.

“This is having a pretty profound impact on our practice,” Latimer said.

Vaccination can prevent monkeypox about 85% of the time if the shot is administered soon after exposure. The first of two shots is ideally administered within four days of exposure, but the vaccine can be effective up to two weeks after if the person has not yet developed symptoms. Vaccines can also be given preventively to people who might encounter the virus.

» READ MORE: Pa. receives first major shipment of monkeypox vaccine, with half of the 450 doses going to Philly

Both Philadelphia and Pennsylvania health departments said they are currently prioritizing vaccine doses for people who have been exposed to the virus, but some health experts have said containing the virus will require making doses available to all people at high risk of catching the virus. So far, cases have been concentrated among men who have sex with men and have recently had two or more sexual partners. The virus is not a sexually transmitted disease, but transmits more easily through close, intimate contact.

Philadelphia’s concerns about an insufficient vaccine supply are being echoed across the country, said CDC director Rochelle Walensky, in a media briefing Friday.

“The demand for vaccine from jurisdictions is higher than our current supply,” she said. “We know this is frustrating.”

Nationally, 1,814 monkeypox cases have been reported. That number will continue to increase in the coming weeks, Walensky said. The virus is still spreading, and, because monkeypox can incubate without symptoms for up to three weeks, it may take that long for some infections to be detected. More streamlined reporting and better access to testing will also boost the count of cases, she said.

In Philadelphia and beyond, the population most at risk for catching monkeypox are experiencing confusion and anxiety about the virus, expressing concerns about the lack of access to information, tests, and vaccines.

“I definitely think there’s a mix of confusion, along with fear, particularly with people who are comparing this with the way they handled other pandemics,” said Sultan Shakir, president of the Mazzoni Center, citing as an example the LGBTQ community’s prior experience with HIV-AIDS.

Similar concerns were raised in a letter to the White House on Thursday from Charlie Crist, a Democratic congressman from Florida, who noted that his office has received dozens of calls from constituents who have found it difficult to find information about the virus or resources to combat it.

“Presently, the disease is overwhelmingly attacking gay and bisexual men,” Crist wrote. “When a community historically marginalized by the public health system feels ignored, brushed aside, and denied diagnostics and preventive treatment, I take it as a gravely serious problem.”

The median age of Americans who have caught the virus is 36, with cases confirmed among people ages 18 to 76. At highest risk are men who have sex with men and have recently had multiple partners. Out of the 700 cases the CDC has detailed demographic data on, eight were reported in people who were assigned female at birth.

There is no biological reason monkeypox would stay limited to the population of gay, bisexual, or trans men.

The virus is most easily spread by skin-on-skin physical contact, touching objects that have been in contact with someone with the virus, and close face-to-face interactions, like kissing.

Stay home, except to get tested, cover lesions, and avoid close skin-to-skin contact or sex with others.

The CDC recommends minimizing sex with multiple or anonymous partners and avoiding events with minimal clothing, a lot of skin-to-skin contact, as well as parties that might involve sexual encounters with multiple people or anonymous partners.

A person is no longer at risk of infecting others when a rash is healed, scabs have fallen off, and the person has a fresh layer of skin.

In Philadelphia and Pennsylvania, vaccines are being prioritized for people who have confirmed or suspected exposure to someone with monkeypox. The Pennsylvania health department said decisions about whether vaccines could be given to someone in a high-risk group, but without a known exposure, would be made on a case-by-case basis.

Pennsylvania reported its doses are being stored at 12 locations around the state, and can be transported anywhere as needed within a matter of hours.

Both Philadelphia and the state, though, hope to make doses available at health centers that provide care for the LGBTQ community when more vaccine is available.

The U.S. Department of Health and Human Services has now allocated about 300,000 doses of vaccine since late May, the agency reported, and Friday placed an order with the Danish company Bavarian Nordic for 2.5 million doses of the vaccine JYNNEOS, doubling the number of doses ordered from the company. Friday’s order won’t arrive until 2023, though.

Federal authorities are slightly changing how vaccines are being allocated, Walensky said. Because a lack of testing meant cases were being undercounted, she said, vaccines had been distributed on the basis of case counts and a region’s average population size. Test access is improving, with four commercial laboratories now processing suspected monkeypox samples along with government labs. As case counts become more accurate, Walensky said, they will shape how vaccine allocation is prioritized.