Chicago prioritizes first monkeypox vaccine dose, delays second shot

Chicago health officials have decided to prioritize the first doses of the monkeypox vaccine, and delay scheduling the second shots, to give as many people as possible their first dose of protection against the spreading virus, the city’s top doctor said Monday.

The biggest increase in protection comes from the first dose, Chicago Department of Public Health Commissioner Dr. Allison Arwady said at a news conference at City Hall on Friday that focused on the virus. The city will make exceptions and more quickly give second doses to immunocompromised people, as well as those who have had contact with someone known to have monkeypox, she said.

“This is the right approach,” Arwady said. “We’ve looked at all the data and feel that that is the best way to control this outbreak.”

The city’s strategy follows other cities, such as San Francisco and New York City, that have chosen to use their limited vaccine supply to inject as many people as possible with first doses to offer the broadest measure of protection.

Chicago health officials are targeting the most at-risk people for vaccines, including men who have sex with men at venues, with multiple or anonymous partners, or for money, Arwady said. Second doses will be scheduled when more vaccines become available, she said.

The city has grappled with vaccine shortages experienced nationwide as it reacts to the viral outbreak. As of Friday, there were 202 cases of monkeypox in Chicago, with 230 reported in the state overall, putting Illinois among the top five states in the country, the city’s health department said.

But Arwady acknowledged at the news conference that the number of reported cases doesn’t tell the full story.

“International, national and local level, this is definitely an undercount,” she said.

The city’s health department reported that Chicago has distributed 5,400 doses to vaccinators and will soon receive an additional 18,000 doses. Chicago will receive 15,440 doses from the federal government as soon as Saturday and anticipates another 2,600 coming from the state, Arwady said.

But the city will need even more, she added — and health officials working on the front lines agree.

[ As monkeypox cases climb in Chicago, Gov. J.B. Pritzker calling on federal health officials to ramp up vaccination efforts ]

“We simply do not have enough vaccines for all those who need it,” said David Ernesto Munar, president of LGBTQ-focused Howard Brown Health Center.

“For that reason, it’s going to be so important for us to continue to expand community education and awareness so that people understand the steps that they can take to evaluate themselves and their partners for any signs or symptoms of monkeypox,” he added.

Those signs include fever, swollen lymph nodes and unusual rashes throughout the body, including on the hands, trunk, genital area and orifices, Munar said.

Howard Brown has targeted Black and other minority gay men for outreach and vaccination, Munar said, citing the more severe impact that dangerous illnesses often have on people of color. The medical center hosted a vaccination clinic at the Silver Room Sound System Block Party last weekend.

Quickly filling vaccination appointments at Howard Brown are currently being scheduled three weeks out, Chief Operating Officer Steven Glass said during a Thursday night monkeypox town hall. The medical center, inundated with concern over the virus, had 1,300 unanswered calls this week, he added.

The city can respond to the outbreak by “blasting information out” as the federal government gets more vaccines to epicenters like Chicago, said Ald. Maria Hadden, 49th, who also spoke at the town hall.

“The education is so important. We have centralized resources, whether it’s putting together promotional pieces on the CTA, reaching out to families in CPS,” Hadden said.

Hadden said she’s worried that it is unclear to most people that monkeypox is not a sexually transmitted infection and can spread to anyone through physical contact.

The virus is generally passed on through close physical contact with a scab or bodily fluids of someone who has monkeypox, as well as contact with objects they’ve touched. Spread could occur through acts like sharing a towel or having intimate sexual contact.

The current outbreak has spread mostly among men who have sex with men. Health officials have repeatedly said that the disease could infect anyone and is currently spreading among men who have sex with men because that is a tight-knit group.

[ Monkeypox concern grows as virus spreads in Chicago: ‘They need to get loud about this’ ]

At Friday’s news conference, Ald. Tom Tunney, 44th, called on men who have sex with men to “be responsible while having sex” by using common sense and limiting partners.

The LGBTQ-geared Northalsted Market Days street music festival will bring hundreds of thousands of people to the city on Aug. 6 and 7. The city will “continue to have a concerted effort” to make sure the massive party is safe and is not considering canceling events or closing venues at this time, Arwady said.

“We’re going to have a lot of visitors coming in over the next month,” Tunney said.

The smallpox-related monkeypox virus was first detected in humans in 1970 and is endemic to parts of west and central Africa. The illness often begins with flu-like symptoms and swelling of the lymph nodes before progressing to distinct, large rashes throughout the body that look like pimples or blisters. Monkeypox can last up to four weeks.

[ WHO again considers declaring monkeypox a global emergency ]

Most Chicago cases have been identified on the North Side, but cases have also been detected in the South and West sides, Arwady said.

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“Anyone who is having possible symptoms of monkeypox, no matter who you are, no matter where you live, get tested,” she said. The city’s testing capacity can meet demand, she added.

A hard-to-secure, Food and Drug Administration-approved antiviral treatment called TPOXX is being used to treat the most severe cases, Arwady said. Around 5% of Chicago monkeypox patients have been hospitalized, and no one has died from the disease, she added.

When asked about the potential for monkeypox transmission through casual contact, such as brushing up on someone in a crowded space, Arwady said the city hasn’t seen any monkeypox cases among the health care workers who have worked with infected patients.

“Some of the more casual contact, it’s possible. But it’s not — based on everything we know now — that high risk,” she said.

“We will obviously continue to monitor as this grows, and I do expect it will continue to grow,” Arwady said.

jsheridan@chicagotribune.com

Twitter @jakesheridan_