Oregon health officials gear up to vaccinate more people against monkeypox

Oregon is gearing up for a wider vaccination campaign to prevent the spread of monkeypox.

The Oregon Health Authority is updating its guidance to providers to encourage them to inject the vaccine just under the skin instead into the fatty tissue in the arm. Under-the-skin shots only require one-fifth of the dose, enabling providers to stretch out supplies.

“We anticipate a switch over by early next week,” Dr. Dean Sidelinger, state epidemiologist, said in a news conference on Thursday.

The state has received just over 6,800 doses of the vaccine against monkeypox, Jynneos, and nearly 2,200 shots have been administered. The vaccine provides full immunity after two doses but the state has recommended getting one shot into as many people as possible to try to curtail the spread. By switching to under-the-skin shots, Sidelinger said he expects most people will be able to get their second shot in two to three months.

The U.S. has had limited supplies of the vaccine because it’s only made in Denmark. That’s prompted Oregon to limit vaccinations to people who’ve had close contact with someone who’s been infected or someone who’s had more than one anonymous sexual partner in the previous two weeks. The virus is spread by skin-to-skin contact, like cuddling, massage, kissing and sex. 

The state is not recommending vaccination among the general public.

“We are vaccinating people who are more likely to have had exposure,” Sidelinger said.

Although children could become infected, there are no pediatric cases in Oregon, and Sidelinger does not expect the outbreak to cause a problem for schools.

Last week, the state’s public health director, Rachael Banks, ordered insurers to cover the cost of the vaccine.

“This is an important step to ensure that no one will be refused a vaccine,” Sidelinger said.

Those infected are asked to isolate until the lesions scab and the scabs fall off, usually in two to four weeks.

Health officials acknowledge that self-quarantining can pose a hardship for someone who cannot work at home. The state has no money or resources to help them, however. Sidelinger said local health officials are trying to help people on a case-by-case basis.

The outbreak, which is worldwide, includes more than 10,000 people in the U.S.

Oregon has 95 cases in seven counties: Clackamas, Columbia, Coos, Lane, Marion, Multnomah and Washington counties. Most of them are gay or bisexual men, though three women have been infected.

Sidelinger said about one-third of the people infected are Hispanic. The Oregon Health Authority has translated information about the disease and where to get vaccinated into Spanish, and it’s working with community groups that advocate for Hispanic people to get the word out.

Sidelinger does not expect the outbreak to end soon.

“We do have community spread here in Oregon,” Sidelinger said. “We will be facing this for months, if not years.”

He advised people who may be susceptible to the outbreak to be aware of any changes on their skin or in the genital or anal regions. The lesions are infectious, though the disease can be spread by body fluids, like saliva during kissing, and people can catch it by handling infected material, like towels or bedding. 

But unlike Covid-19, which spreads through airborne particles, monkeypox is not spread among people on a bus, for example, or in a room with someone who’s infected unless there is close, prolonged contact, health officials say.

One person in Oregon has been hospitalized. The lesions can be painful. 

“Some people have some really complicated wounds,” Dr. Patrick Luedtke, Lane County’s senior public health officer, said in the news conference. “They can have secondary infections.”

The lesions can cause scars, too. Sidelinger recommended that patients cover the sores or put an anti-lotion or ointment on them to prevent touching them. Sores in the eyes can cause blindness.

Health officials urge anyone who suspects they might have monkeypox to get a test. Results are usually available in a maximum of three days, Luedtke said.