HHS Still Mulling Whether Monkeypox Is a Public Health Emergency

WASHINGTON — HHS is not yet declaring the monkeypox outbreak in the U.S. to be a public health emergency, but they are taking more steps to fight it, including increasing vaccine stockpiles and making more monkeypox tests available.

“We continue to monitor the response throughout the country on monkeypox,” HHS Secretary Xavier Becerra said Thursday morning on a call with reporters. “And we will weigh any decision on declaring a public health emergency based on the response received throughout the country. The bottom line is, we need to be able to stay ahead of this and end this outbreak.”

When pressed further, he added, “You can’t end it if you’re falling behind. That’s why we have procured more than a million vaccines already, even though there have only been less than 5,000 cases,” and why the administration also has made many more tests available than are currently being used, he said.

Becerra also announced that the administration is making available an additional 786,000 doses of the Bavarian Nordic monkeypox vaccine, adding to the 338,000 doses already distributed. Dawn O’Connell, JD, administrator for strategic preparedness and response at HHS, noted that the agency will open ordering for additional vaccines on Friday, and will switch over to a more centralized ordering system starting on Monday.

“At the start of the outbreak, HHS had purchased an additional 5.5 million doses of the JYNNEOS vaccine on top of the over 1 million we already [had],” she said. “We are continuing to work with our supplier to identify opportunities to further expand and accelerate availability of this critical vaccine. When including doses already distributed, the federal government will have secured more than 6.9 million vaccine doses by the end of 2023.”

In addition to the more than 1 million doses already distributed, “we also have 15.1 million doses in bulk drug substances that our manufacturers are holding in storage for us,” O’Connell said. “We intended that to be [part of] our program for smallpox preparedness, but we have immediately begun putting all of those doses … into our monkeypox response.”

“Right now, we have ordered 5.5 million doses to be fill-finished over the course of the next several months,” she continued. Along with the more than 1 million doses already distributed, “that equals that 6.9 million total that I mentioned, but that also leaves 11.1 million doses we could fill-finish pending additional funding.” Any doses not used for monkeypox response will be put toward the smallpox preparedness program, “so we will use all the vaccines one way or the other,” O’Connell added.

Capt. Jennifer McQuiston, DVM, MS, deputy director of the High Consequence Pathogens and Pathology division at the CDC, gave the latest case numbers: as of July 27, about 20,000 cases of monkeypox had been reported globally, including more than 4,600 cases in the U.S. spread across 48 states and territories. The median age of the U.S. cases is 35, with an age range of 17 to 76, not counting the two cases reported in children, McQuiston said. Nearly all of the cases were in patients assigned male gender at birth, and the vast majority were men who have sex with men. In terms of racial/ethnic characteristics, 37% of patients were white, 31% were Hispanic/Latino, 27% were Black, and 4% were Asian.

The four most common symptoms reported were rash (reported in 99% of cases), malaise, fever, and swollen lymph nodes; chills and muscle pain were also reported, she said. “The CDC strongly encourages all providers to be on high alert for patients presenting with monkeypox symptoms, and to test any patients where monkeypox is suspected.”

The Biden administration is also working to educate providers about the illness. “Just a couple of days ago, the CDC held a call with some 10,000 clinicians to give them whatever information they needed and answer any questions they had,” said Becerra. In addition, “every week, CDC holds a call with relevant jurisdictions and healthcare officials with state and local governments, and on a daily basis, CDC is in touch with clinicians, officials, and community members … that might be impacted as well.”

As for the funding for dealing with monkeypox, Becerra said his agency has “communicated to Congress what we’re looking for in terms of resources and authorities to be able to move forward, to stay ahead of monkeypox and end this outbreak … We will continue to provide whatever information and technical assistance they request of us.”