Maryland officials said Tuesday that they continue to press federal sources for limited doses of the monkeypox vaccine and keep close tabs on the rising cases in the state, but with just over 2% of the country’s total infections, Gov. Larry Hogan has not followed other states in declaring it a health emergency.
Maryland has 129 cases, according to the U.S. Centers for Disease Control and Prevention, below the infections recorded in three states that have declared emergencies that give leaders extra powers to protect residents. The states are California with 827 cases, Illinois with 520 cases and New York with 1,390 cases. In all, 9 states and Washington, D.C., each have more cases than Maryland.
Nonetheless, Hogan said in a statement, the state is working to contain the outbreak.
“Since before our first monkeypox case was identified, the state has been mounting an aggressive response to this outbreak in coordination with local and regional partners,” he said.
“While vaccine supply from the federal government is severely limited at this time, anyone who believes that they may need testing or treatment should contact their healthcare provider or local health department immediately,” he said. “We will keep pressing the federal government to provide more vaccines to the states and do all we can to make resources available to those at risk.”
So far, the state has received enough to vaccinate 3,202 people with the two-dose Jynneos vaccine, which can be given before or after exposure. Officials have said they are sending it to the most affected areas of the state, including Baltimore City and the Washington suburbs, though it’s not clear how many doses remain on hand.
After saying last week that they initially received 200 doses, Baltimore health officials said Tuesday that they received 500 additional doses — enough for a total of 350 people, with some new doses reserved for second shots in the series. State officials had no update on how doses had been distributed, but previously said they sent 200 doses each to Baltimore and Montgomery and Prince George’s counties and reserved 82 doses for other jurisdictions.
In Baltimore, the vaccine will be limited to those who have had two or more casual or anonymous sexual partners in the past two weeks and are men who have sex with men, transgender women, nonbinary people assigned male sex at birth and people who engage in transactional sex of any gender. Those who meet the criteria can contact the health department’s Eastern Sexual Health Clinic (410-396-9410) or the Druid clinic (410-396-0176) beginning at 9 a.m. Thursday.
The first case of monkeypox was identified in Maryland in mid-June, after an outbreak spread from Europe to the United States.
The cases are unusual outside of African countries where it’s endemic, though largely spread from animals and not human to human, and the response from federal leaders to the outbreak has been criticized as slow. U.S. officials are scrambling now to distribute vaccine and produce more doses. Only limited supplies had been kept in the nation’s strategic stockpile.
Monkeypox is rarely fatal but causes painful swollen lymph nodes, fevers and lesions that can spread the disease to close contacts. Isolation is necessary. For now, most cases have been reported in men who have sex with men, but public health officials have warned that others are at risk if they come in contact with the lesions or contaminated surfaces, such as bedding or clothing, for example.
Maryland health officials say they have sought to equitably distribute the vaccine to those exposed and health care workers, per CDC guidance. They also are tracing contacts from each case and working with medical providers to recognize more cases, refer patients for testing and educate the public without stigmatizing groups of people who already may feel marginalized by the health care system.
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Dr. Jinlene Chan, deputy health secretary for public health, said the state will work with what it has.
“We want to emphasize that the goal is limiting the spread of the virus and vaccinating those who may have been exposed in the prior two weeks,” she said in a statement. “Due to the limited supply of the vaccine from the federal government, the state is working closely with local health partners to make doses available in a manner that focuses on locations that have case counts and higher-risk populations. We plan to expand access to the vaccine as more supply becomes available.”
Federal health officials say they are working on that vaccine supply. In a July 29 statement, the U.S. Food and Drug Administration said it has ordered more of the Jynneos vaccine, approved in 2019 for monkeypox and smallpox. About 800,000 doses are expected to be released this fall following inspections are the plants where the vaccine is made. More doses are expected to follow.
The officials also continue to expand where the FDA-approved diagnostic test is available, which includes commercial and state labs. The tests, which require swabbing a lesion, must be ordered by a medical provider.
There currently are no specific treatments for the disease, though an antiviral medication called TPOXX is being made available under the FDA’s “expanded access” authority as trials continue to show its safety and efficacy.
“The FDA has been closely tracking reports of monkeypox transmissions in the United States with our federal public health partners and coordinating preparedness efforts accordingly,” said Dr. Robert M. Califf, FDA commissioner, in a statement in the agency’s July 29 update.
“We understand that while we are still living with COVID-19, an emerging disease may leave people feeling concerned and uncertain, but it’s important to note that we already have medical products in place, specifically an FDA-approved vaccine for the prevention of monkeypox disease and an FDA-cleared diagnostic test,” he said. “The FDA is using the full breadth of its authorities to make additional diagnostics and treatments available. We will continue to collaborate with our partners across all sectors to expand accessibility to countermeasures and bolster the tools in our arsenal as appropriate.”