Access to monkeypox vaccination in Alaska was expanded with a two-tiered system announced Wednesday, Aug. 3. This came only one day before the United States Department of Health and Human Services declared a federal public health emergency in response to the rapid spread of the virus nationwide. Due to low availability, the monkeypox vaccine is administered only in response to potential exposure. The Centers for Disease Control and Prevention recommend that the vaccine be given within four days of exposure, but also state that it may be given up to 14 days after exposure.

The Alaska Department of Health’s Division of Public Health announced the move to the two-tier system in an update to providers. The first tier includes those 18 and older who are notified by a public health official that they meet the CDC’s definitions of high or intermediate degree of exposure.

High exposure includes those who have had unprotected skin-to-skin contact with an infected person, especially those who have had sexual contact, as well as being exposed to bodily fluids or discharge from skin lesions. Intermediate exposure includes being within 6 feet of an infected person for more than three hours or having one’s clothes exposed to the skin lesions or bodily fluids of an infected person. These tiers can also be assigned by public health officials based on unique circumstances.

Individuals are also eligible for a vaccine if they are alerted by someone other than a public health official that they may have been exposed.

The second tier of vaccine eligibility includes gay or bisexual men who have had multiple partners in the past 14 days. The Division of Public Health says this group is identified as being at high risk because a large proportion of cases are occurring among gay, bisexual and other men who have sex with men. People of any gender or sexual orientation can contract the virus, however, and anyone who has been in close contact with a person infected with monkeypox is at risk.

The Division of Public Health notes that it may not be possible to vaccinate everyone who is eligible at this time.

The 2022 monkeypox virus outbreak was first identified in the United States on May 19, in Boston. As of Monday, it has spread to 49 states, with 8,934 cases reported nationwide, according to the CDC. The virus was first identified in Alaska on July 28, and by Monday, only one other case had been reported.

According to the CDC, a key symptom of monkeypox is a rash, commonly located around the genitals or other areas like the hands, feet, chest, face and mouth. Other symptoms of the virus include fever, chills, swollen lymph nodes, exhaustion, muscle aches, headache and respiratory problems like sore throat and cough. Symptoms usually begin to appear three weeks after exposure, and can last two to four weeks.

Monkeypox was first identified in captive monkeys in 1958. The first human case was detected in 1970. The virus has largely been reported in central and west African countries, though cases have been reported outside Africa with links to international travel or importation of animals like rodents and monkeys. Officials have not identified a direct link between the current outbreak and any such travel.

More information about the monkeypox virus can be found on the CDC’s website at cdc.gov/poxvirus/monkeypox. Additional information about monkeypox in Alaska can be found on the Department of Health’s website at health.alaska.gov/dph/Epi/id/Pages/Monkeypox.aspx.