LA County supervisors push for increased monkeypox vaccine supplies, funds

In the face of limited supplies of vaccine and growing public concern, the Los Angeles County Board of Supervisors agreed Tuesday to lobby federal health officials to bolster local supplies of monkeypox vaccines and boost funding for testing and administration of the shots.

Local health authorities have repeatedly insisted that the odds of contracting monkeypox in the general population are extremely low. But growing case numbers, particularly among gay men, have been heightening public concern about a disease usually restricted to the African continent but now being detected globally.

As of Tuesday, there were 218 known cases in Los Angeles County. That’s up from 120 last week. The county has also confirmed local transmission of the virus, noting that some patients had no known history of recent travel.

The county has been slowly expanding eligibility for the JYNNEOS monkeypox vaccine, but supplies remain extremely limited.

In a motion that went before the Board of Supervisors Tuesday, Supervisors Hilda Solis and Janice Hahn noted that future vaccine supplies remain uncertain.

“With the current supply, it is estimated that only 5%-10% of the population that wants to be vaccinated will be reached,” according to the motion. “Given the vaccine can be administered both pre- and post-exposure and the continued spread of the monkeypox virus throughout Los Angeles County, additional vaccine supplies will be needed to expand vaccine eligibility to both prevent further spread and to provide an effective treatment to those who have been exposed.”

The motion also notes that some community health providers have reported that “reimbursement rates for administering monkeypox testing, vaccination and treatment are inconsistent and unsustainably low to support their efforts. In addition, providers remain concerned about their ability to serve the uninsured population without designated funding for these services.”

Under the motion, which was approved unanimously, the county will send a letter signed by all five supervisors to federal health authorities requesting additional supplies of the vaccine in the county, along with efforts at a national level to increase production of the vaccine and the establishment of “sustainable reimbursement levels … for monkeypox testing, vaccine administration and treatment.”

The letter will also call for the establishment of a funding source to reimburse clinics, hospitals and other health care facilities providing such services for uninsured residents.

In Los Angeles County, monkeypox vaccines are available to people confirmed by the Department of Public Health to have had high- or immediate- risk contact with a known monkeypox patient, and to people who attended an event or visited a venue where they was a high risk of exposure to a confirmed case. Those people are generally identified through county contact-tracing efforts, and they will be notified by the county.

The county also recently expanded eligibility to residents who meet a select criteria, saying they could obtain a vaccine from their health care provider, or with a referral from a health care provider or through a self- referral to a vaccine clinic.

Those referrals are available for gay and bisexual men and transgender people with a diagnosis of rectal gonorrhea or early syphilis within the past year.

Also eligible for the shots are gay or bisexual men or transgender people who are on HIV pre-exposure prophylaxix, or PrEP, or who attended or worked at a commercial sex venue or other venue where they had anonymous sex or sex with multiple partners — such as at a sauna, bathhouse or sex club — in the past 21 days.

People who believe they fall into any of the criteria can contact their health care provider to see if that provider can administer the vaccine.

Qualified people who do not have a health care provider — or whose provider does not carry the vaccine — can either make an appointment at a designated vaccine clinic or visit a walk-in location. Information is available at ph.lacounty.gov/monkeypox. A list of monkeypox vaccine locations is available at http://publichealth.lacounty.gov/chs/DPHMonkeypoxSchedule.pdf.

Last week, the county also activated a website where residents can fill out an online form to see if they may be eligible for a shot and pre- register to be added to a waiting list.

People who register at the site and are eligible for the vaccine will receive a text message when it is available and with information on where to get the shot.

The registration website is ph.lacounty.gov/monkeypoxsignup.

The vaccine is a two-shot regimen, so additional supplies will be reserved to provide second doses to those who received the initial shot.

Health officials said the infection spreads through contact with bodily fluids, monkeypox sores or shared items such as bedding or clothing that were contaminated with fluids. It can also be transmitted through saliva and sexual contact.

Most people who develop monkeypox have only mild illness that goes away within two to four weeks without treatment. People with symptoms are urged to visit a medical provider, cover the rash area with clothing, wear a mask and avoid close or skin-to-skin contact with others. The U.S. Centers for Disease Control particularly recommends those steps for people who recently traveled to an area where monkeypox cases have been reported, or who have had contact with a confirmed or suspected monkeypox cases.

A full list of countries that have confirmed monkeypox cases is available at https://wwwnc.cdc.gov/travel/notices/alert/monkeypox.