HONOLULU (KHON2) — Three states have declared a state of emergency as monkeypox cases continue to rise nationwide, Hawaii health officials said the risk remains low in the state, but those at high risk should consider making an appointment for a vaccine.

California was the latest state to declare a state of emergency over monkeypox on Monday, the CDC said cases in the golden state surpassed 800.

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In Hawaii, the Department of Health has confirmed 11 monkeypox cases in the state.

“When you look at the especially the number of monkeypox we’ve had here, it’s been mostly in Hawaii residents,” DOH Communications Director Katie Arita-Chang said. “And I think that’s really important to remember travel is always a could be a possible vector for disease. It was definitely seen in the COVID pandemic, but at this time, the risk remains low here in Hawaii.”

One case has been confirmed on Kauai and another on the Big Island, the rest are on Oahu.

The DOH said it has taken more than 400 vaccine appointments since vaccines became available.

So far the federal government has allocated 1,400 vaccines for the islands.

Arita-Chang said, “That’s not enough for everyone who wants in here in Hawaii.”

The DOH is prioritizing those who may have been exposed to monkeypox and communities most at risk.

Health officials said monkeypox is not as easily transmitted as other viruses.

The CDC said it is most often transmitted through skin-to-skin contact, sharing towels and bedding, as well as prolonged face-to-face contact.

Arita-Chang said, “You are eligible for a monkeypox vaccine if you’ve been exposed to someone with monkeypox in the last two weeks, or if you identify as a man who has sex with men, and in the last few weeks are in an area or in an activity where you may be have exposure to monkeypox.”

More community healthcare partners are being added to administer the monkeypox vaccines, and as more clinics are added more appointments will become available.

Meanwhile, they continue to advocate for all of the doses the state can get, but the CDC is prioritizing states with outbreaks.

Arita-Chang said, “If you think that you have monkeypox, you know, you have an unusual rash, especially if it’s really itchy or sore, you have a fever with swollen lymph nodes, and then a rash, definitely contact your health care provider right away.”

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DOH is taking appointments for monkeypox vaccines through its hotline.