As monkeypox cases climb and vaccine is in short supply, some Texas cities declare an emergency

Federal officials are also holding additional doses for states in case they’re needed before the CDC can re-up this winter and “may be released later depending on the status of the outbreak and vaccine administration data,” according to a notice sent to local health officials earlier this week.

Houston, where more than 200 cases have been confirmed, has received nearly 12,000 doses of the vaccine. San Antonio, with 16 confirmed cases, has obtained 1,000 doses. Tarrant County has received 1,100. None of those localities are expected to declare public health emergencies over monkeypox in the near future. The state has several hundred in its stockpile to “for state facilities and filling in gaps that arise,” DSHS spokesperson Chris Van Deusen said.

Austin has received more than 3,100 doses of the monkeypox vaccine. But given the spread of the disease in Austin, that supply is “running out,” Walkes said this week. The local supply of vaccine doses will be down to about 200 by the end of this week, Walkes told Austin’s city council on Thursday.

Strategies for deploying the vaccine in each public health region are up to the local officials and may vary, although state health officials are instructing providers to administer only to those who meet certain high-risk criteria or who have already been exposed through close contact, Van Deusen said.

Some counties, such as Dallas, are allowing appointments to be made only over the phone — with no current online appointment system — and are administering the vaccines in clinics where patients’ privacy can be protected.

Van Deusen said that because different communities have different needs, the state has not specified who each local department can authorize to administer vaccines.

“They know the communities and at-risk populations in their area,” Van Deusen said. “They may choose to administer the vaccine themselves or work with public or private providers who serve particular populations or both. I wouldn’t assume one approach will be the best approach everywhere.”

More people eligible

After weeks of limiting the vaccine only to people who have had intimate skin contact with someone who tested positive for the virus, the state on Tuesday began to allow providers to administer them to certain high-risk people before exposure — a move patient advocates have said would be critical in containing the virus.

Those the state considers to be currently at the highest risk are primarily men who have sex with men and who have had multiple or anonymous sex partners over the past 21 days.

The vaccine can prevent onset even after exposure, scientists say, and can mitigate symptoms in those who do contract it.

The state also now allows people under 18 to get the injections if they are at high risk.

Broader eligibility means potentially more vaccine recipients, but state and federal officials are trying to prepare for that, too.

The U.S. Food and Drug Administration this week approved the administration of the vaccine in a shot injected under the skin, much like a tuberculosis test, as opposed to into body fat, like more traditional vaccines. By offering the shots in this way, only a fifth of the full dose is needed for each person.

“In recent weeks, the monkeypox virus has continued to spread at a rate that has made it clear our current vaccine supply will not meet the current demand,” said FDA Commissioner Dr. Robert M. Califf. “This will increase the total number of doses available for use by up to five fold.”

The method can stretch a vial of vaccine, but it requires specialized training to administer and certain types of needles and syringes.

Dallas County, where more than 200 cases have been confirmed, has received more than 5,000 doses to date but will soon begin using the new injection method approved to stretch those doses and inoculate more people as officials expect numbers there to continue to rise rapidly, Dallas County Judge Clay Jenkins told The Texas Tribune.

North Texas has one of the highest concentrations of cases compared with the rest of the state, state officials said.

“We don’t have enough vaccine to get to all the populations who are at risk of monkeypox based on where the outbreak is right now,” Jenkins said. “That’s the bottom line.”

Public health departments have personnel trained in the administration method but DSHS still has to procure enough specialized syringes and needles before they can start doing the shots intradermally, Van Deusen said.

When and if the vaccine is given to private providers, additional training will be needed, which could take more time, he said.

“We’re certainly recommending it as a way to stretch the supply, but it’s not an instant fix,” Van Deusen said.

Disclosure: Steve Adler, a former Texas Tribune board chair, has been a financial supporter of the Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.

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