With monkeypox cases now totaling 139 in Ohio, 61 in Cuyahoga County, health officials increase local vaccine rollout

CLEVELAND, Ohio — As Cuyahoga County cases of monkeypox have now reached at least 61, local health officials on Wednesday detailed plans to ramp up distribution of the monkeypox vaccine and responded to criticism that the rollout has been slow.

There have been at least 15,909 cases nationwide, including 139 in Ohio, the Centers for Disease Control reported Tuesday. Ohio’s first confirmed case was reported June 14. Cleveland reported its first 11 cases on Aug. 8.

City of Cleveland Department of Public Health Director Dr. David Margolius, Cuyahoga County Board of Health Commissioner Dr. Roderick Harris, and Cuyahoga County Board of Health medical director Dr. Prakash Ganesh spoke about monkeypox and COVID-19 during a virtual press briefing.

There are plans to distribute the monkeypox vaccine to hospitals, community-based organizations, entertainment venues and places where residents seek other social services, officials said.

County and city health workers recently distributed more than 200 vaccines at a popular gay bar, at the Cleveland Department of Public Health and at the Cuyahoga County Board of Health headquarters in Parma.

“Based on the limited supply received, we are committed to vaccinating as many people as possible to prevent disease,” Cleveland health officials said in a statement. “As more vaccine is allocated to Cleveland, we will be setting up more clinics to make it available to a larger group of at‐risk persons.”

There were 41 monkeypox cases in Cleveland on Wednesday, according to a new Cleveland Department of Public Health tracker.

About 61% of the Cuyahoga County cases are in the city of Cleveland, and 60% of those residents are African-American. The ages of patients range from 19 to 50, Harris said.

The local response to the monkeypox outbreak has not been slow, Harris said.

“I would rather consider our response thoughtful,” Harris said. “We have been working to make sure that one we’re reducing stigma as much as possible in our response to monkeypox.”

Many monkeypox patients so far are Black, have HIV, and are from systematically oppressed and our vulnerable populations, Margolius said.

Margolius praised the region’s vaccine approach because it did not put in a system that favored those who had the fastest internet connections or who are the most well off or the least likely to live in the city.

“We’ve been very thoughtful with this approach, and sometimes promoting equity and being thoughtful takes a little bit longer,” Margolius said.

Local health officials gave further updates on monkeypox. Here are highlights:

Monkeypox vaccine clinic Friday: The Cleveland Department of Public Health will hold a second monkeypox vaccine clinic from 3-9 p.m. on Friday at 1313 E. 26th Street, Cleveland. Vaccines are free and confidential. No pre‐registration or appointment is necessary.

Because vaccine supply is limited, those who are eligible for the shots must be 18 and over and also fall into one of the following categories:

* Those who have had unprotected contact between a person’s skin or mucous membranes and the skin, lesions, or bodily fluids from a patient or contaminated materials, such as linens or clothing.

* People who have attended events or venues linked to known monkeypox transmission.

* People who have had or are likely to have prolonged intimate contact that puts them at higher risk of being exposed to monkeypox virus.

* Those who have not previously been diagnosed with monkeypox or do not currently have signs/symptoms of the illness.

Individuals who currently or previously were sick with monkeypox are not eligible for the vaccine clinics, because a vaccination given after the onset of symptoms is not expected to be beneficial, Cleveland health officials said.

People immunized against monkeypox should continue to avoid close, skin‐to‐skin contact, including intimate contact, with someone who has monkeypox. Fully vaccinated individuals are still recommended to protect themselves against monkeypox.

Anyone with concerns or symptoms should talk to their healthcare provider.

Monkeypox vaccine rollout: In early August, the county received 1,200 vials of monkeypox vaccine from the Ohio Department of Health, Harris said. At the time, 1,200 vials were equivalent to 1,200 doses of the vaccine.

Because supplies were limited, the county ensured that its clinical partners — including MetroHealth System, the Cleveland Clinic, University Hospitals and selected clinics — had the vaccine, Harris said.

The plan changed in mid-August, when the county received notification that one vial could be used to give five vaccines. “We thoughtfully consider expanding our reach to other populations,” Harris said.

Monkeypox transmission: The illness is not a sexually transmitted infection, but it can be transmitted sexually because of how the virus has spread. It is spread by skin-to-skin contact, so sexual encounters will certainly contribute to the outbreak, Harris said. Most cases are among individuals who identify as gay, bisexual, or a man who sleeps with men, but that is not exclusive.

“It is just what we’re seeing right now with this current outbreak,” Harris said.

It can spread between people who are kissing, and through non-sexual encounters with skin-to-skin contact,

Monkeypox symptoms: These include headache, chills, swelling of the lymph nodes, upper respiratory tract symptoms such as cough, sore throat and fever and fatigue. A painful and itchy rash that starts flat on the surface and then develops into a bump that sometimes weeps pus.

People who are at high risk of severe monkeypox are those who are immunocompromised, have HIV or have multiple sexual partners.

People should isolate if they do show signs or symptoms of monkeypox and talk to their primary care doctor for advice.