Since monkeypox was first detected in Utah this May, there have been 32 confirmed and probable cases of the virus reported throughout the state.

Twenty-seven of those cases have been reported in Salt Lake County, along with three in Utah County, according to the Utah Department of Health and Human Services.

One case was also reported out of Davis County, and another was reported out of the Weber-Morgan Health Department. No cases have been reported in southern Utah.

The first two monkeypox cases identified in the state were some of the first in the country. Since then, there have been over 5,000 cases of monkeypox reported nationwide, with over 2,000 of those in New York and California. The World Health Organization recently declared the monkeypox outbreak a global health emergency, with over 21,000 confirmed cases worldwide.

Nicholas Rupp, a spokesperson for the Salt Lake County Health Department, said that Salt Lake County has received the majority of monkeypox vaccine doses that the Centers for Disease Control and Prevention has allocated to Utah for two main reasons: the county is seeing a higher incidence of cases, and it tends to serve more of the “men who have sex with men” (MSM) community than surrounding jurisdictions.

Anyone can catch monkeypox, but Rupp emphasized that as of late, the health department is not seeing the virus spread throughout the general community. That’s why only people who have had close contact with someone with monkeypox, and members of the MSM community who have multiple sexual partners, are currently eligible for the county’s limited vaccine doses, since the virus right now is largely spreading within that population. Men who have sex with men who are in monogamous, exclusive relationships with one other person do not qualify at this time.

“If we see data that indicates we have a population that is experiencing cases, then we’re going to shift our tactics to address that additional population as well,” Rupp said. “The key is to be nimble, so that we can make the vaccine available to the populations that the data is telling us are at risk.”

Salt Lake County received its first doses of the vaccine in early June, which were administered to people who had been exposed to the virus. The county received a larger supply of doses the week of July 11 and held its first vaccination clinic on July 14, where 525 people received a dose. Last week, the county received another shipment and began its third round of vaccinations for higher-risk populations on July 22.

From July 14 through next week, about 900 people will have received one dose of the two-dose monkeypox vaccine from the county health department, Rupp reported.

Second doses, which cannot be administered until at least 28 days after receiving a first dose, will not be available until mid-August.

“We feel like things are, so far, pretty under control here locally,” Rupp said. “The public health system has responded efficiently and quickly.”

To minimize monkeypox spread, those experiencing symptoms of the virus should immediately isolate and tell their close contacts and partners to keep an eye out for symptoms, officials advise. Contact your local health department, your health care provider or visit a clinic near you. Then, get vaccinated as soon as you are eligible.

What to know about the monkeypox vaccine

The Salt Lake County Health Department has been administering the JYNNEOS vaccine to those eligible, which has been approved by the U.S. Food and Drug Administration to prevent smallpox and monkeypox.

The JYNNEOS vaccine consists of two doses given at least 28 days apart. Individuals are fully vaccinated 14 days after their second injection. While the second dose is needed for full protection from the virus, Rupp said that the first dose does provide robust protection.

“The MSM community has been enormously responsive and responsible in getting the message out amongst themselves and coming in and getting vaccinated,” Rupp said. “They want the vaccine. This isn’t the case where we’re having to ask people, ‘Please come get vaccinated,’ like we have been with COVID.”

“That’s really helpful to public health,” he continued. “When we have more demand than supply, that can be a good problem.”

The monkeypox vaccine can prevent someone from contracting the virus and can also mitigate the severity of illness, as long as it is given to an exposed person within four days of their exposure.

Much like the COVID-19 vaccine, the populations eligible for vaccinations will change as vaccine doses become more widely available. As that happens, the health department plans to offer outreach clinics throughout the county and through its community partners, Rupp said.

The health department has partnered with Equality Utah, the Utah Pride Center and the Utah AIDS Foundation to ensure that pertinent information about monkeypox reaches the populations currently at risk, including that the virus is not exclusively sexually transmitted.

Since May, Ahmer Afroz, executive director of the Utah AIDS Foundation, said that the organization has fielded many calls from the community, mostly asking about monkeypox prevention and vaccinations.

“We are really well-trusted within the population in the communities that we serve, which also happens to overlap with who is most impacted by monkeypox at this point in time,” Afroz said.

All of Salt Lake County’s available vaccine doses have been allocated to future appointments at this time. Rupp said Friday that the health department is not sure when the next shipment of monkeypox vaccines will arrive in the state, or how large that shipment will be.

Monkeypox messaging: ‘A fine line’

When the Salt Lake County Health Department encountered the state’s first two monkeypox cases in May, officials knew they needed to be proactive about monkeypox messaging. The virus has been spreading largely within the MSM community, but misinformation could lead to homophobia and panic.

There are parallels between messaging about the monkeypox and the early days of the HIV/AIDS epidemic in the 1980s, Afroz said. At the outset of that epidemic, AIDS was first termed “Gay-Related Immune Deficiency.”

As monkeypox has spread over recent months, data shows that almost all current cases are within the MSM community — for now.

“That could change tomorrow,” Rupp said.

“On one hand, if we are so careful in our messaging, we’re going to miss the population we need to reach; we’re not going to be specific enough or direct enough with them to get them the information they need to protect themselves,” he added. “But on the other hand, if we’re too specific and too direct about what the data is telling us, it could create vilification and stigma in the larger community for the MSM or GLBTQ community. So it really is a fine line to balance.”

Other communities that could next be affected by monkeypox could include sex workers, people experiencing homelessness or those who struggle with intravenous substance use disorder, Rupp added.

For now, the health department is focusing its available vaccine supply within the MSM community because that is where the virus is primarily spreading.

“When we create this hysteria that [monkeypox] is a ‘gay disease,’ or that it’s only related to men who have sex with men, then we encourage people not to access health care,” Afroz said. “And then we’re creating hysteria where they absolutely don’t want to engage because we’ve created this unsafe environment.”

Salt Lake City man who tested positive speaks out

Addison Jenkins, who lives in Salt Lake City, found out about a free, local monkeypox vaccine clinic through Facebook and received his first dose on July 14 before traveling to San Diego for a Pride event. While in California, he and three friends stayed in the same hotel room, occasionally sharing towels, clothing and drinks.

After returning to Salt Lake City, a few of Jenkins’ friends and those they had been in contact with learned that they had tested positive for monkeypox. Jenkins himself started experiencing flu-like symptoms such as fever, aches and chills last week. He tested positive for the virus on Wednesday.

“My case, as far as I know, was a nonsexual transmission,” he said.

An important distinction, Rupp emphasized, is that monkeypox is not a sexually transmitted disease. It can be spread through sexual contact, but also on linens, clothing, other surfaces and even through respiratory contact.

Jenkins wrote about his experience in a Twitter thread to combat that kind of misinformation that he said he’d seen online. He had also noticed people questioning why monkeypox vaccines were only available to men who have sex with men.

“That, to me, is so wrongheaded,” Jenkins said. “It’s it’s very clear that the monkey pox is spreading predominantly within the queer male social network. So focusing our resources and our messaging on that right now is really important. And it’s really helpful that the gay male network is distributing that information within itself.”