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A vaccine shot (via Arlington County/YouTube)

Have you had sex with multiple partners — or someone whose name you don’t know — over the past two weeks?

If so, you’re now officially eligible for a monkeypox vaccine in Arlington.

Arlington County has widened its previous vaccine eligibility criteria to include people of all genders and orientations who are engaging in potentially risky sexual behavior. That includes those who “have had anonymous or multiple (more than one) sexual partners in the last two weeks.”

As before, sex workers or staff of “establishments where sexual activity occurs” are included regardless of gender.

Arlington’s health department, meanwhile, has launched a new online request system for the JYNNEOS monkeypox vaccine.

Arlington County has recorded a total of 54 monkeypoxes since the outbreak began, according to Virginia Dept. of Health data. That’s up from 39 cases on Aug. 15.

About 4,700 people in Northern Virginia have received the monkeypox vaccine so far, according to VDH.

More from an Arlington County press release, sent Thursday afternoon, below.

The Arlington County Public Health Division (ACPHD) has expanded eligibility for the monkeypox virus vaccine and launched a new appointment request process.

The expanded vaccine eligibility aligns with current Centers for Disease Control and Prevention (CDC) and Virginia Department of Health (VDH) criteria and now includes Virginia residents of all ages of any sexual orientation or gender who meet one of the following:

  • Have had anonymous or multiple (more than one) sexual partners in the last two weeks; OR
  • Are a sex worker; OR
  • Are a staff member at an establishment where sexual activity occurs (bathhouses, saunas, sex clubs, etc.)

The criteria for being vaccinated may be updated in the future.

Close contacts of known cases continue to be eligible and prioritized for the monkeypox vaccine.

ACPHD also launched a more streamlined process to request an appointment for a first dose of the monkeypox vaccine. People who meet the eligibility criteria can request an appointment by visiting acphdmpv.timetap.com. ACPHD will review all requests to verify eligibility before confirming the appointment.

Starting this week, ACPHD also began administering the monkeypox vaccine using the intradermal (in between the layers of the skin) method and dose in accordance with federal and VDH guidelines. People ages 18 years or older who received their first JYNNEOS dose by the subcutaneous (under the skin) method will receive their second dose by the intradermal method to complete their vaccination series.

Monkeypox is a contagious rash illness caused by the monkeypox virus. In most cases it resolves without treatment. It is spread by close contact with an infected person. Close contact includes touching skin lesions, bodily fluids, or clothing or linens that have been in contact with an infected person. Spread can also occur during prolonged, face-to-face contact.

While anyone can catch monkeypox if they have close contact with someone with the virus regardless of gender identity or sexual orientation, many of those affected in the current global outbreak are gay, bisexual, or men who have sex with men. People with monkeypox in the current outbreak generally report having close, sustained contact with other people who have monkeypox.

Currently, the highest risk activity is having sex with multiple or anonymous partners. Avoiding these activities greatly reduces one’s risk of catching or spreading monkeypox. Monkeypox does not spread from person to person from walking past someone who is infected or through casual conversation with someone who is infected.

If someone has a new or unexpected rash or sores, they should work with their health care provider to determine the cause. Health care providers in Arlington can visit ACPHD’s Monkeypox for Healthcare Providers website for more information and how to contact us should they have questions.

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Covid cases in Arlington as of 8/15/22 (via Virginia Dept. of Health)

The rate of reported Covid cases continues to slowly fall in Arlington, while the number of monkeypox cases slowly rises.

The local seven-day moving average of new Covid cases is now 83 cases per day, down nearly 60% since Memorial Day, according to the latest Virginia Dept. of Health data. Separate data from the CDC suggests that hospitalizations have risen over the past week, from 6.6 per 100,000 residents per week to 8.4.

The county, meanwhile, saw about one new monkeypox case per day over the past week. All seven new cases since last Monday — Arlington has reported a total of 39 cases since the start of the monkeypox outbreak — are among male patients, according to VDH data.

Arlington’s health department says its monkeypox vaccination effort is continuing, with nearly 700 vaccine doses administered as of this past Thursday.

From a county press release:

The Arlington County Public Health Division (ACPHD) continues to respond to the ongoing spread of the monkeypox virus and is working with community partners to ensure those who have been exposed or are at highest risk of exposure to monkeypox receive a vaccination.

ACPHD continues to provide monkeypox vaccine to close contacts of known cases and those at increased risk of exposure to reduce their chances of developing monkeypox. ACPHD has been offering the vaccine since late June and is currently operating clinics by appointment only six days a week. As of Aug. 11, 2022, ACPHD has administered 699 total doses of monkeypox vaccine.

Vaccine appointment invitations are being extended to those who have completed the Monkeypox Vaccine Interest Survey (open to all Virginia residents) AND meet the eligibility criteria. As new vaccine shipments arrive, ACPHD will issue new appointment invitations. The eligibility criteria may change as the outbreak evolves and based on vaccine supply.

Vaccine supply remains limited nationwide. ACPHD has been working with the Virginia Department of Health (VDH), which authorizes the priority groups for the monkeypox vaccine and allocates vaccine doses to local health districts.

On the Covid front, Arlington County is ending its local emergency declaration today, as planned. The nearly two-and-a-half year-long state of emergency gave county leaders greater powers to respond to the pandemic.

From a county press release this morning:

The Local Emergency for Arlington County, originally declared in response to the public health threat posed by the Coronavirus (COVID-19), ends on Aug. 15, 2022.

The declaration, which went into effect on March 13, 2020, was established to assist in the response and recovery efforts related to the COVID-19 pandemic. It allowed the County to shift to virtual operations, including online permitting, appointments, remote inspections, County Board and Commission meetings, as well as public comment.

“The declaration has been an important tool offering the flexibility needed to better serve our residents, businesses, and visitors,” said County Manager Mark Schwartz. “The added authorities under an emergency, such as the ability to alter procurement, hiring and zoning rules has served us well.  However, as we have learned to cope with a pandemic that will be with us for many months to come the need for these emergency authorities has dwindled.”

Many of the new tools, strategies, and approaches borne out of the pandemic will continue as the County moves beyond the local emergency declaration

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Colorized transmission electron micrograph of monkeypox virus particles (photo via NIAID)

Arlington is now setting up appointment-only clinics to vaccinate against monkeypox as cases continue to rise across the region.

The Virginia Department of Health has expanded access to the monkeypox vaccine to “those groups at increased risk for exposure,” per Arlington health department spokesperson Sondra Dietz, allowing the county to run the clinics.

The Arlington County Public Health Division is now running clinics 6 days a week, Monday through Saturday, by appointment only, Dietz told ARLnow. As of this morning, 511 total doses of monkeypox vaccine have been administered by the county health department, another spokesperson said.

The county is asking anyone is who interested and is eligible to receive the vaccine to fill out the vaccine interest form. The form is open to all Virginia residents and not just Arlingtonians; so far, there is no word on how many people have filled out the form.

Just over two weeks ago, ARLnow reported that the county was not yet planning any clinics due to VDH’s “limited” supply of monkeypox vaccine JYNNEOS. It appears that since that time VDH has started to provide more vaccine supply to individual localities. This has allowed Arlington to proceed with vaccinating those in high-risk groups, not solely those “contacts of known cases.”

“As ACPHD receives new vaccine shipments, we will issue new appointment invitations,” writes Dietz.

To be eligible to get the vaccine in Virginia, an individual must be a Virginia resident and 18 years or older. Per the county and VDH, the criteria to receive the vaccine also include:

Within the last 14 days are:

  • Gay, bisexual, and other men who have sex with men and have had multiple or anonymous sexual partners; OR
  • Transgender women and nonbinary persons assigned male at birth who have sex with men; OR
  • Sex workers (of any sex); OR
  • Staff (of any sex) at establishments where sexual activity occurs (e.g., bathhouses, saunas, sex clubs); OR
  • Persons (of any gender or sexual orientation) who attend sex-on-premises venues (e.g., bathhouses, sex clubs)

NOTE: If you had monkeypox, then you likely have some protection against another infection and are currently not eligible to be vaccinated.

The county also noted that eligibility “may change as the outbreak evolves and based on vaccine supply. ”

This comes as the federal government declared monkeypox a “public health emergency” late last week and cases continue to rise across the region.

As of today, VDH is reporting that there are 32 known and confirmed cases of monkeypox in Arlington. That encompasses just under a quarter of all the cases in Virginia. A majority of people who have monkeypox are between 20 and 39 years old and are white or Black, per VDH data.

Of the 145 people with monkeypox in Virginia, all but one are reported to be male.

Number of monkeypox cases in Arlington and Virginia as of Aug. 8 (image via VDH)

Monkeypox is spread primarily through close or intimate skin-to-skin contact. Anyone can get and spread the illness, though there are higher risk groups.

Symptoms usually start appearing a week or two after exposure and can include blister-like rash, fever, body aches, and exhaustion. The symptoms can last 5 to 21 days.

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Colorized transmission electron micrograph of monkeypox virus particles cultivated and purified from cell culture (photo via NIAID)

Though monkeypox cases continue to rise in the region, the county has yet to open vaccine clinics for the disease.

Supply of the monkeypox vaccine JYNNEOS remains “limited,” county spokesperson Ryan Hudson tells ARLnow, and Arlington is coordinating with the Virginia Department of Health to obtain and administer doses.

However, at this moment, there are no planned vaccine appointments or clinics to administer those doses in Arlington to those who are at higher risk and might have been exposed in the last 14 days.

“VDH is still working to expand vaccine access for Virginians who are at higher risk of being exposed to monkeypox and meet CDC criteria,” Hudson wrote ARLnow in an email. “Information about who will be eligible and how they get vaccinated will be provided when it becomes available both on the VDH site and County site.”

This is in contrast to D.C., which made limited, pre-registered monkeypox vaccine appointments available late last month.

While monkeypox cases are rising in Virginia, they remain relatively low compared to the District which has the highest rate of monkeypox cases per capita in the country.

As of this morning (Wednesday), the Virginia Department of Health is reporting that there are 56 cases of monkeypox in the Commonwealth. Three-quarters of those cases, 42, are in the Northern Region, which includes Arlington.

Number of monkeypox cases in Virginia as of July 20, according to VDH (image via VDH)

This is a relatively rapid rise from only a few weeks ago when, in late June, VDH announced there were only 8 cases in the entire Commonwealth. The first case in Northern Virginia was detected back in late May.

County Manager Mark Schwartz spoke briefly about monkeypox at the County Board meeting yesterday afternoon.

“Our Public Health Division is coordinating with the Virginia Department of Health and local health care providers to test for potential cases and to provide guidance on isolation and treatment,” Schwartz said. “We are reaching out also to and monitoring all contacts of potential cases.”

He also noted that the vaccine supply is “pretty limited” and “only being offered to residents who are at high risk of getting monkeypox and have likely been exposed in the last 14 days.”

Monkeypox can spread through direct contact with infectious rashes, scabs, body fluids, or through “respiratory secretions,” according to the CDC. This includes having “prolonged, face-to-face contact” or “intimate physical contact, such as kissing, cuddling, or sex” with someone who is infected.

The virus can spread to and make anyone sick, though the highest risk groups at the moment are men who have had sex with men and with multiple partners over the last several weeks, sex workers, transgender women and nonbinary persons who have sex with men, and people who work in places where sex occurs like saunas and bathhouses.

The CDC and VDH define “higher risk” as those who are in these groups and might have been exposed over the last 14 days.

Health agencies have struggled with messaging, in that the virus is impacting the male gay community more at this moment but agencies do not want to further stigmatize an already marginalized group.

Monkeypox causes rashing and potentially other symptoms over a course of several weeks. The West African type that’s making its way around the globe is “rarely fatal,” says the CDC website, though “symptoms can be extremely painful, and people might have permanent scarring resulting from the rash.”

If one is already infected with monkeypox, health officials note, the vaccine is not an effective treatment.

“If someone suspects they have a monkeypox infection, they should contact a healthcare provider,” writes Hudson.

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Colorized transmission electron micrograph of monkeypox virus particles cultivated and purified from cell culture (photo via NIAID/Flickr)

Update at 3:30 p.m. — The Virginia Dept. of Health says it has confirmed the first monkeypox infection in the state.

Earlier: A Northern Virginia woman likely has monkeypox, the Virginia Dept. of Health announced today.

In a press release Thursday afternoon, VDH said the woman was isolating at home and not hospitalized. She became infected after recently traveling “to an African country where the disease is known to occur.”

The state health department did not say where in Northern Virginia the woman lives.

If confirmed, it’s Virginia’s first case of the viral disease, which has been spreading internationally. In the U.S., cases have been reported in several states including New York, Florida, Washington and Massachusetts.

VDH noted that monkeypox remains rare and has “not shown the ability to spread rapidly in the general population.” The disease can be serious and cause death and there’s no specific treatment for it.

The full press release is below.

Today, the Virginia Department of Health (VDH) announced the first presumed monkeypox case in a Virginia resident. The initial testing was completed at the Department of General Services Division of Consolidated Laboratory Services. VDH is awaiting confirmatory test results from the Centers for Disease Control and Prevention.

The patient is an adult female resident of the Northern region of Virginia with recent international travel history to an African country where the disease is known to occur. She was not infectious during travel. She did not require hospitalization and is isolating at home to monitor her health. To protect patient privacy, no further information will be provided. The health department is identifying and monitoring the patient’s close contacts.  No additional cases have been detected in Virginia at this time.

“Monkeypox is a very rare disease in the United States.  The patient is currently isolating and does not pose a risk to the public.” said State Health Commissioner Colin M. Greene, MD, MPH. “Transmission requires close contact with someone with symptomatic monkeypox, and this virus has not shown the ability to spread rapidly in the general population. VDH is monitoring national and international trends and has notified medical providers in Virginia to watch for monkeypox cases and report them to their local health district as soon as possible. Based on the limited information currently available about the evolving multi-country outbreak, the risk to the public appears to be very low.”

Although rare, monkeypox is a potentially serious viral illness that is transmitted when someone has close contact with an infected person or animal. Person-to-person spread occurs with prolonged close contact or with direct contact with body fluids or contact with contaminated materials such as clothing or linens. Illness typically begins with fever, headache, muscle aches, exhaustion, and swelling of the lymph nodes. After a few days, a specific type of rash appears, often starting on the face and then spreading to other parts of the body. Symptoms generally appear seven to 14 days after exposure and, for most people, clear up within two to four weeks. Some people can have severe illness and die. As with many viral illnesses, treatment mainly involves supportive care and relief of symptoms.

If you are sick and have symptoms consistent with monkeypox, seek medical care from your healthcare provider, especially if you are in one of the following groups:

  • Those who traveled to central or west African countries, parts of Europe where monkeypox cases have been reported, or other areas with confirmed cases of monkeypox during the month before their symptoms began,
  • Those who have had contact with a person with confirmed or suspected monkeypox, or
  • Men who regularly have close or intimate contact with other men.

If you need to seek care, call your healthcare provider first. Let them know you are concerned about possible monkeypox infection so they can take precautions to ensure that others are not exposed.

On May 20, 2022, VDH distributed a Clinician Letter to medical professionals reminding them to report any suspected cases of monkeypox to their local health department as soon as possible and implement appropriate infection prevention precautions.

For more information, visit the Centers for Disease Control and Prevention websitethe World Health Organization website and the VDH website.

Photo via NIAID/Flickr

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