Shantel Destra and Candace Pedraza, THE CITY
The rollout of the monkeypox vaccine in New York City has been riddled with technical difficulties, communication issues and a major shortage of doses.
To date New York City has received a total of 7,000 doses. When the first 1,000 doses arrived at the Chelsea Sexual Health Clinic in early June, appointments were filled almost immediately while the people who booked those waited for hours in long lines at the clinic as the demand for the vaccine — with each patient needing two shots, administered four weeks apart — far exceeded the supply.
In early July, the New York City Department of Health and Mental Hygiene announced that 6,000 new doses of the vaccine had arrived only to pause bookings because of appointment portal glitches. Health Commissioner Ashwin Vasan tweeted an apology for those glitches, and said the city would “do better in the days and weeks ahead.”
New York City currently has the highest number of monkeypox cases in the country, and an additional 14,000 vaccine doses are expected to be sent here by mid-July, health department officials said at a July 11 town hall on the outbreak.
State and city health officials have urged the federal government for more monkey vaccines because of rising cases; Mayor Eric Adams pushed for additional doses in a letter sent to President Biden on July 11.
With all the confusion, you may be wondering about the specifics of the contagious viral disease, who’s at risk and how concerned you should be.
We’re here to help. Here’s a guide on what to know about the monkeypox outbreak:
What Is Monkeypox?
Monkeypox isn’t new. It was first discovered in the 1970s, according to the World Health Organization and since then, cases have primarily been linked to international travel to places where the disease is common, including central and west Africa.
The cause of the disease — which is part of the orthopoxvirus family along with smallpox — is unknown.
The Centers for Disease Control and Prevention has identified fever, headache, chills, and swollen lymph nodes as symptoms of monkeypox. Those infected are also known to have pimple-like rashes that may appear on the face, hands, feet, and inside of the mouth. The infection can last anywhere from 2 to 4 weeks.
How Does Monkeypox Spread?
Monkeypox can spread through direct contact with infected skin, bodily fluids, and intimate physical contact as outlined by the CDC. The disease can also spread through indirect contact with fabric — such as bedding, clothing, and linen — that has been on infected areas of the skin.
As of July 12, the number of people who’ve tested positive for monkeypox in New York City is low, with around 267 cases. But that’s up from around 100 cases just a week before.
Many experts said the increase in a cause for concern.
“Any number of health experts will tell you they could see the writing on the wall to know that increased community spread was going to happen,” Christian Grov, professor at CUNY School of Public Health.
That spread, in turn, is an opportunity for the disease to “become better adapted to humans, and transmit more efficiently,” said Stephen Morse, a Professor of Epidemiology at the Columbia University Medical Center.
“These numbers are usually the tip of the iceberg,” said Wafaa El-Sadr, professor of epidemiology and medicine at Columbia University’s Mailman School of Public Health. “In all likelihood there are probably more people that are infected who haven’t been tested.”
Experts told THE CITY that more vaccine doses are needed, with El-Sadr adding that there’s a pressing need to inform the public about the ways the disease is transmitted and its symptoms.
“We cannot allow complacency from people thinking it’s just a few hundred cases,” she said.
Who’s Most At Risk?
The CDC has identified gay, bisexual and other men who have sex with men as making up a high number of cases, based on early data.
Vasan said at the July 11 town hall that there is “nothing intrinsic about the disease” that makes it a bigger risk for those men, but rather that “this current outbreak happens to be concentrated at the moment — and that started this way — amongst social networks and sexual networks of gay, bisexual, and men who have sex with other men.”
Experts who spoke with THE CITY agree that having a targeted approach to vaccinate groups presently at a higher risk for contracting monkeypox may slow the spread of the disease.
According to El-Sadr, the city health department should “think creatively” in expanding vaccine distribution to sexual health clinics and other locations across the city, building off of lessons learned from the COVID-19 vaccination efforts.
“You can’t expect people to go to you. You’ve got to meet people where they are,” she said.
Where Can I Get the Monkeypox Vaccine?
As of the second week of July, monkeypox vaccines in New York City are being offered by appointment from the health department to people who meet all of the following criteria:
The vaccine is also being offered to people who’ve been informed by the health department that they’ve been in contact with someone with monkeypox.
To schedule an appointment, visit the NYC Department of Health website. Be warned, however: the site has repeatedly gone down as it’s been overwhelmed by traffic.
All available monkeypox vaccine appointment slots have been booked. Due to overwhelming traffic, as soon as appointments went online this afternoon, the site delivered error messages for many people who were unable to make appointments.— nychealthy (@nycHealthy) July 12, 2022
As of July 13the city health department said monkeypox vaccines will be available at the following locations:
- Chelsea Sexual Health Clinic, 303 Ninth Ave. in Manhattan
- Central Harlem Sexual Health Clinic, 2238 Fifth Ave. in Manhattan
- Corona Sexual Health Clinic, 34-33 Junction Blvd. in Queens
Two Vaccines — What’s the Difference?
There are two types of vaccines used to treat monkeypox: JYNNEOS and ACAM2000. JYNNEOS is the vaccine that is being made available by the city. It is approved by the FDA for prevention of monkeypox for people over 18 years old and, once again, is administered in two doses, four weeks apart. You are considered “fully vaccinated” two weeks after receiving the second dose.
The monkeypox vaccines, which are more commonly used to protect against smallpox, have been found to be very effective according to the CDC. Even if you have contracted monkeypox, the vaccine is still effective in preventing more severe symptoms.
The second vaccine sometimes used to treat monkeypox, known as ACAM2000, carries risks for pregnant and immunocompromised people, has serious side effects and requires multiple needle jabs, according to reporting by The Atlantic.
Why Are There So Few Vaccines Available?
The JYNNEOS vaccine is made by a small company in Denmark with a manufacturing facility that has been shut down since last August, The New York Times previously reported.
In late June, The White House released an outbreak response to distribute an initial 56,000 vaccines immediately to “jurisdictions with the highest number of cases and population at risk,” with 1.5 million vaccine doses following over the next few months.
On June 30, Gov. Kathy Hochul announced that 8,165 doses would soon become available in New York State. Just over a week later, the city’s health department announced the 6,000 vaccines.
At the town hall on July 11, Vasan and New York State Health Commissioner Dr. Mary Bassett and Vasan referred to New York City as the “epicenter for monkeypox” and complained that New York was not receiving an adequate supply of doses from Washington.
“We’ve gotten an allocation of 14% [of national vaccines] with 27% of the cases,” said Dr. Bassett. “But whatever these numbers are, there has not been enough vaccines. It’s clear that more vaccines are needed.”
Both Vasan and the mayor have discussed the idea of spacing out the two doses of the vaccine in order to get first doses to more people.
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