State health leaders are hoping monkeypox infections are beginning to flatten out, but vaccine supply remains strained.
"We communicated to the CDC several weeks ago that we needed at least 600,000 to 800,000 doses to vaccinate the at-risk population in California — right now we don't have enough," California Public Health Officer Dr. Tomás Aragón said during a briefing with reporters Friday.
Aragón said some 66,000 doses had been sent out statewide, with more arriving soon. At least 2,660 monkeypox cases have been reported in California with 192 in San Diego County. Statewide 62 people have been hospitalized with no known deaths.
"The vast majority of transmission is happening in men who have sex with men," Aragón said. "So persons who are in a setting where they have more sexual partners are more likely to transmit the virus because they’re having contact with more people. Even though this is being spread through sexual activity, it’s not what we’d consider a traditional sexually transmitted disease."
Aragón said monkeypox was not a "traditional STD" because it is transmitted through close contact with rashes or lesions that can appear anywhere on the body. They can be extremely painful and typically develop along with flulike symptoms after infection. Transmission can also occur through sharing bedding, towels or unwashed clothing. Prolonged face-to-face interactions are also included.
Anyone can get monkeypox. Health officials do not want to stigmatize and are working with LGBTQ groups to reach those most at risk.
"No single individual or community is to blame for the spread of any virus," Aragón said.
California is also releasing new guidance for people who get monkeypox. It asks people to avoid close contact and lets them know how to protect others.
"If they can cover up the lesions completely, the lesions have stopped increasing for 48 hours, they don’t have a fever, they’re feeling well and they’re completely covered up — then they can resume normal activities," Aragón said.
With monkeypox vaccine supplies strained nationwide, doses are being prioritized for the people most at risk or potentially exposed. Supplies are being stretched with injections being done just under the skin. The FDA recently gave emergency use authorization for a process called intradermal injections, which turns one dose into five and works just as well.
"It is the same, if not a little bit better even," said UC San Diego Health Infectious Disease Specialist Dr. Francesca Torriani.
Torriani said staff from UC San Diego Health had already been trained and were now using the dose-saving injection method. A San Diego County Health and Human Services spokesperson said Friday they plan to start using the intradermal process next week at county clinics. Torriani said targeted vaccinations are key to stopping monkeypox.
"Vaccination is really important to do now — not to delay that so that we don’t have secondary transmissions outside of the current population," Torriani said.
Infections are spreading. At least three people in San Diego County's cases have identified as being homeless.
During Friday's briefing Aragón was asked about case numbers potentially trending down, and he said he was hopeful.
"Whenever you look at the numbers, there is always a delay in reporting, so we're always cautious about that," Aragón said. "I'm hoping that we're beginning to flatten out a little bit."
Torriani said she doubted that San Diego County has reached the peak of infections.
"I think simply because we started to detect disease a little bit later than other jurisdictions," she said.
Aragón said that, at the state level, officials are trying to avoid using the term "monkeypox" and instead calling it MPX or M-Pox, but did not give a specific reason for why.
