King County to split 1 monkeypox vaccine into 5 doses after FDA emergency authorization

The monkeypox vaccine shortage in King County isn’t going away, but a major announcement from the White House on Tuesday could change that.

The U.S. Food and Drug Administration gave emergency use authorization to split one dose of the monkeypox vaccine into five doses. The change means providers can now give the shot in a shallower location right under the skin instead of deeper in the arm. According to the White House monkeypox response team, the different shot location and smaller dose was found to generate a similar immune response.

New numbers from the Washington State Department of Health show cases of monkeypox are rising -- now at 223 cases statewide. A majority of them are in King County, where there are 189 cases.

And as the virus spreads, people are getting increasingly worried.

“I just wanted to be precautionary, I do hang around a lot of people and I didn’t want to put myself at risk if I could just get a vaccine for it,” said Nick Pennington, who was at Harborview Medical Center hoping to get a vaccine.

However, he discovered at the wellness clinic he’s not eligible.

“Based off of why I didn’t qualify is you have to be sexually active. And if you’re not then – you just need to check back in a week or two,” Pennington said.

“I know there is a tremendous demand for this vaccine,” said Dr. Jeff Duchin, public heath officer for Seattle-King County.

The Public Health – Seattle & King County website says vaccine is in “scarce supply” and currently eligibility criteria for the monkeypox vaccine are prioritized for people at the highest risk, including:

• People who have had sexual, close intimate contact or other high risk close contact with someone who has tested positive for monkeypox.

• People at high risk of recent exposure to monkeypox, including men who have sex with men who have recently had multiple sexual or intimate close contact partners including:

  • Gay, bisexual, or other men or transgender people who have sex with men AND
  • At least one of the following:
  • More than 10 sex partners in the prior 3 months
  • History of early syphilis or gonorrhea in the prior year
  • Methamphetamine use in the prior month
  • Attendance at a bathhouse, other public sex venue, or group sex (sex including at least 3 people at the same time) in the prior 3 months
  • Experiencing homelessness/unstable housing AND currently living in a congregate setting AND had any sexual activity in the prior 3 months.

“I didn’t think that it was going to be what it was,” Pennington said about the eligibility requirements.

Duchin said right now, the county has only received 11% of the monkeypox vaccine it’s hoping to get.

But the changes announced by the FDA and the Centers for Disease Control and Prevention would expand the vaccine’s reach fivefold.

“It’s a game changer when it comes to our response and our ability to get ahead of the virus,” said Robert Fenton, the White House National Monkeypox Response Coordinator.

The current method uses one vial, or dose, that gets injected into your arm. The new method uses a smaller needle and a provider would deliver a shallower shot, injecting one-fifth of a vial right under your top layer of skin.

The monkeypox response team said studies found the shallower shot using less vaccine generates a similar immune response.

“We encourage jurisdictions to use the alternative dosing method as quickly as possible,” Fenton said.

Duchin said Tuesday afternoon given that the announcement was just made, it is still waiting on additional guidance from the CDC – for instance, whether the smaller needles will be provided. Some will also need to be trained to deliver the shallower shot.

“I doubt we’d be able to pivot to this new way of doing things as early as this weekend but I would not say it’s out of the question,” Duchin said.