The Biden administration announced Thursday it has secured an additional 786,000 doses of monkeypox vaccine, as the federal government works to contain cases of the virus that has infected more than 4,600 Americans.

Combined with the more than 338,000 vaccine doses already distributed to states and territories, the additional shots bring the total number of doses already administered or in hand to around 1.1 million. 

“At the Department of Health and Human Services, our goal is pretty straightforward: Stay ahead of the virus and end this outbreak,” HHS Secretary Xavier Becerra said in a call with reporters. “At HHS, we're doing everything we can in that regard.”

As of Wednesday, there had been 4,639 confirmed monkeypox cases in the United States, more than any other country during the outbreak, according to the Centers for Disease Control and Prevention. Infections, which have more than doubled in the past week, have been found in all but four states, led by New York (1,228) and California (799).

Globally, there have been more than 20,000 monkeypox cases confirmed in 77 countries.

In addition to sending vaccine doses to states, the federal government has ramped up testing capacity from 6,000 a week to between 60,000 and 80,000. Becerra said nearly 10,000 Americans have been treated for monkeypox with the TPOXX pill.

Health officials say they will have secured 6.9 million monkeypox vaccine doses by mid-2023 and that there are 1.7 million oral treatment doses in the national stockpile. 

But pressed on how many Americans have been vaccinated, health officials couldn’t provide a number, saying they don’t have adequate data from the states.

Becerra said the federal government does not have the authority to give orders to states on vaccinations and urged them to do their part.

“We want to continue to stay ahead of this,” the health secretary said. “We don't control public health in the 50 states, in the territories and in the tribal jurisdictions. We rely on our partnership to work with them. They need to work with us.”

Becerra, however, insisted the federal government can stay ahead of the virus. 

With the additional vaccine doses, officials said they are updating their distribution plan to prioritize the total population of people at risk in an area and the number of new cases in a community since the previous allocation. The Biden administration also wants to ensure jurisdictions have enough doses to complete the two-dose regimen of the Jyennos vaccine. 

Jennifer McQuiston, deputy director of the CDC’s Division of High Consequence Pathogens and Pathology, said 99% of Americans infected with monkeypox are male or assigned male sex at birth, and the vast majority have reported engaging in close male-to-male contact.

The median age of patients is 35, she said. The first two pediatric monkeypox cases in the U.S. were reported last week. 

Symptoms include rash, malaise, tiredness, fever, swollen lymph nodes, chills, headaches and muscle pains. There have been no deaths associated with the outbreak.