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CLEVELAND (WJW) — Cuyahoga County’s response to the monkeypox outbreak may seem frustratingly slow, officials said Wednesday — but that’s because vaccine rollouts in the city and county are emphasizing equity.

Health officials during a media briefing Wednesday said they’re prioritizing the county’s 1,200 allocated doses of the JYNNEOS monkeypox vaccine for those most at risk. The U.S. Centers for Disease Control and Prevention’s latest guidance urges health officials to distribute vaccines to communities that need it most, or that have been disproportionately impacted.

There are currently 41 reported cases of monkeypox in the city. Of the county’s 61 total cases, 60% are African-Americans, Roderick Harris, the county’s health commissioner, said Wednesday.

Similar to most of the about 15,000 cases reported nationwide as of Tuesday, the majority of the local cases are among men who have sex with other men, or who identify as gay or bisexual. Though monkeypox is not a sexually transmitted disease, it can be spread by skin-to-skin contact during sexual encounters, Harris said.

‘Get these vaccines in arms’

On Sunday, city health workers administered more than 200 vaccines at a “popular” LGBT bar in the city; on Tuesday, another 75 doses were at another establishment just blocks from the city health department’s Erieview Plaza offices, said the department’s new director, Dr. David Margolius.

“Most of the folks who have come down with monkeypox are Black, many have HIV, many have been systematically oppressed and are [part of] vulnerable populations in general,” he said. “We did not, on day one, put up a website and offer vaccines to folks who had the fastest internet connections or who were the most well-off or who were the whitest or who were the least likely to live in the city.

“Promoting equity and being thoughtful takes a bit longer.”

The U.S. Food and Drug Administration earlier this month allowed the JYNNEOS vaccine to be administered just beneath the top layer of skin, rather than in the fatty layer beneath the skin. That’s expected to allow health officials to further stretch the available supply.

City and county health officials then decided to expand their reach to community clinics — not just hospital partners, Harris said.

“We’re working with community-based organizations to get these vaccines in arms in these neighborhoods where people are living, and also in venues where they may be entertained and also where they are going to seek other social services,” he said.

Where to get the shot

Two-hundred doses of the free monkeypox vaccine clinic were given Tuesday at the board of health offices, 5500 Venture Drive, Parma. Another clinic is set for this Friday, Aug. 26, from 9 a.m. to noon and from 1 p.m. to 4 p.m. Residents can register online, but it’s not required.

More county-run clinics will be set for next Tuesday and Friday, Harris said.

Also on Friday, Cleveland’s health department will be at the city’s FLEXSpas night club, 1313 E. 26th St., from 3 p.m. to 9 p.m.

To be eligible, vaccine recipients must be age 18 or older, at high risk for monkeypox, have been recently exposed, or have or are likely to have prolonged intimate contact which puts them at risk for exposure. Here’s more information on the virus and vaccines.

The current eligibility tier includes folks of “any sexual orientation that would be at higher risk of contracting monkeypox,” sex workers or people who have HIV or are immunocompromised, said Dr. Prakash Ganesh, the county health board’s medical director.

Those who’ve previously contracted monkeypox are not eligible. Vaccination after the onset of symptoms “is not expected to provide benefit,” according to a Wednesday news release from the city health department.

‘A lot less infectious’ than COVID-19

Ganesh said though monkeypox is “a lot less infectious” than COVID-19, and its overall risk to the community is “generally low,” residents should stay cautious.

Medical workers have noted symptoms can arise between five and 25 days after exposure, he said Wednesday.

“Before a rash develops … people are often developing headaches, chills, swelling of the lymph nodes, upper respiratory tract symptoms such as cough, sore throat, as well as fever or fatigue,” Ganesh said.

The rash that forms may first be flat, then become bumpy. It may be painful or itchy, he said.

Those who are exposed should monitor themselves for symptoms for 21 days, he said.

TPOXX, an antiviral medication used to treat monkeypox, is available at the county health board offices and at the county’s various hospital partners, Ganesh said.