The Maryland Department of Health recently broadened monkeypox vaccine eligibility requirements to reach more residents. At the same time, the state’s top infectious disease official says cases are trending downward. Maryland health clinics began offering the monkeypox vaccine to residents who are at high risk on Sept. 19, not just those who have been exposed to the disease within the prior two weeks.
Individuals who have more than one sex partner, men who have sex with men and immunocompromised people are now eligible to get the vaccine under the new guidance.
Peter DeMartino, the Director of the Maryland Infectious Disease Prevention and Health Services Bureau, said that the state has entered a new phase in its monkeypox response strategy.
“Pre-exposure prophylaxis is really about those who may have been exposed, but also those who might anticipate exposures,” DeMartino said.
The focus is now to vaccinate anyone who may be at risk for exposure to curb the spread, he said.
“We really are working with our local health departments who know their communities best,” he said.
Health departments statewide should have enough monkeypox vaccines for any resident who is at high risk of exposure or who has been exposed, he said.
Monkeypox is a virus that spreads between people through direct contact with skin lesions. Symptoms may include a fever, body aches, chills, fatigue and potentially rashes and lesions on the face and hands. Some people may require hospitalization but most recover within a month.
Vaccines were in short supply earlier this year as the number of infections across Maryland grew from dozens to hundreds in a few months. The federal government shipped out shots to states in batches.
The monkeypox vaccine injected in a special way, known as intradermal injection, enables health officials to stretch how many doses can be administered from each vial.
“Normally, a vaccine goes in under the skin,” DiMartino said. “By actually injecting into the skin, there's lots of good guy cells who can gang up on that little bit of vaccine and create more antibodies. We might now be able to vaccinate five individuals, which completely changes our parameters of how many vials we would need in order to vaccinate a certain number of people.”
The vaccine to protect against monkeypox, similar to the COVID-19 vaccines, is delivered in two doses administered about a month apart.
There have been 662 monkeypox cases across the state as of Sept. 30, the most recent data available. The majority of those cases are in Prince George's County and Baltimore City.
Nearly 6,500 people have received their vaccinations in the state, health department data shows.
DiMartino said the numbers are trending in the right direction, but there is still serious risk.
“The reality of it is, right now, we're seeing cases decreasing,” he said. “Things are where we want them to be. We are optimistic.”
Members of the LGBTQ community are also dealing with social shaming about the disease that has been spreading most among men who have sex with men.
“The stigma makes it hard to interact with LGBTQ people because they think we are disease ridden,” said Ngaire Philip, the community development organizer at Baltimore Safe Haven, an organization focused on helping at-risk LGBTQ youth.
The LGBTQ community has already dealt with stereotypes and misconceptions during the HIV and AIDS epidemic during the 1980s, which advocates say has been reignited as monkeypox spreads.
“That’s the biggest ramification is that it feels that it has reignited those old stigma about being in contact and around LGBTQ people,” Philip said.
The state health department is trying to combat misconceptions and connect with those who need the most help without alienating them.
“Stigma literally means a mark,” he said. “We're making a mark on people's skin. Most people are going to think about putting it on the forearm, but you can put it on the deltoid [where it’s less noticeable]. It’s thinking through the process and experience for people.”
