Health

Why monkeypox vaccine is in limited supply right now


Wasthma The New York City Department of Health announced on July 12 that monkeypox vaccination appointments are available at several locations around the city, demand is too high causing the scheduling site to crash. All appointments are booked within hours, making it impossible for many people to capture.

Vaccine deployment shouldn’t go like this. When cases of monkeypox were first detected in the US in May, experts were reassured. They emphasize that — unlike COVID-19 when it first emerged — monkeypox is a known threat, with vaccines are available can be deployed as needed.

But reality was more confusing. Vaccine supplies are limited, distribution is limited, and it can be difficult to prioritize those most at risk for vaccination. As a result, at least in some regions, demand is overwhelming available supply.

“Everybody wants to get vaccinated, and there are not enough vaccines,” said Dr. “You have a little Hunger game approach.”

The shortage can be surprising, since officials previously said countries have enough vaccines in the Strategic National Stockpile (SNS). But many in stock are the older ACAM2000 vaccine, which is approved for use against smallpox and can also be used for monkeypox. It’s a live virus vaccine that contains a virus related to smallpox but is milder. The shot causes a temporary sore at the injection site which – if not properly cared for – can potentially spread the virus to unvaccinated people through close contact. About 1 in 175 ACAM200 recipients also experienced swelling of the heart and surrounding tissues. Some people who are immunocompromised are also unable to get the ACAM2000 shot.

A newer vaccine called Jynneos, which consists of two doses given four weeks apart and is approved for use against monkeypox and smallpox, is considered preferable to use. widely. The US only had about 2,000 doses of that product on its SNS when the outbreak started – so authorities are rushing to collect more.

Nearly 800,000 Jynneos injections could be available for use by the end of July, when the U.S. Food and Drug Administration (FDA) is expected to license a Danish manufacturing facility run by the manufacturer. Bavarian Nordic operated. Some of Jynneos’ footage was taken at an authorized third-party facility, allowing the US to place an immediate order. As of July 15, more than 300,000 doses have been made available to states and local jurisdictions, according to the US Department of Health and Human Services. Officials say by mid-2023, the United States will have nearly 7 million doses of monkeypox vaccine.

At a press conference July 15, the director of the US Centers for Disease Control and Prevention (CDC), Dr Rochelle Walensky acknowledged that the vaccine shortage was “disappointing” but said the main rights are actively working to increase the supply. Federal health officials will send more doses of the drug to jurisdictions that are seeing high case rates, she said. New York, California, Illinois, Florida, Georgia and Washington DC have become early hotspots, accounting for more than half of the 1,814 confirmed cases nationwide as of July 15.

Mark Levine, the president of the Manhattan borough in New York City, says he feels inadequate doses have been sent to hard-hit areas. “We really don’t get our fair share here,” he said, noting that New York accounts for nearly a third of the cases nationwide. “Most people are turning away.”

New York City Officials recently announced that they will prioritize giving the first dose to as many at-risk people as possible to prolong the supply, meaning that some people may have to wait longer than the designated four weeks for a second dose. CDC and FDA officials advised against this approach during the press conference, noting that individuals are not adequately protected after a single dose.

Ideally, public health officials would use a “round vaccination” strategy against monkeypox, prioritizing vaccination of people known to have been in close contact with an infected person to protect those most at risk and maximize the available vaccine supply, says Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health.

But according to Andrew Kilianski, an infectious disease expert and teaching assistant at George Mason University, inadequate testing and contact tracing has made it difficult to identify infected people and contacts. National testing capacity has grown from about 6,000 tests a week at the beginning of the outbreak to 70,000 now, according to federal health officials, but Kilianski said screening remains inadequate.

“If you are going to distribute your vaccines intelligently and purposefully, you need to know who the positives are,” says Kilianski. “Without a lot of testability, [even] for a pathogen that we are ‘preparing’ for. “

Health departments in hotspots like New York City and Washington, DC, have made the vaccine widely available to men who have sex with men and have had multiple sexual partners recently. Although anyone can get monkeypox – which is spread mainly through close contact and can lead to a blistering rash and flu-like symptoms – the men concerned Homosexuality has accounted for the majority of cases in the United States to date.

“When you’re thinking of just vaccinating contacts, it’s not going to be much demand in terms of supply,” Adalja said. But if anyone meets some broad criteria and thinks they are at risk they can get a vaccine, then “demand is much higher than supply.”

Levine adds that in New York City, the monkeypox vaccine rollout has seen a number of similar cases. equity issues arise in the distribution of COVID-19 vaccines—Specific issues with online appointment scheduling.

“When you have a [scheduling] the system asks you to sit down and refresh the website at a certain hour of the afternoon, that will [benefit] younger, tech-savvy people but not the kind of job that prevents them from sitting in front of a computer,” he said. “Followed communities and people of color are underrepresented as vaccinated populations.” (Since its system crashed, New York City has moved the system to schedule and schedule more appointments.)

If COVID-19 shows us anything, it is that the “last mile” of distribution — actually making available doses of vaccines to those who need them — must be done carefully. kidney, Kilianski said. He wants to see more widespread testing for monkeypox, which would make it easier to identify who may have been exposed. He said the vaccine should also be offered to high-risk people without an appointment.

Texting is also important, Kilianski adds. While targeted communication to men who have sex with men has worked well, as evidenced by the high demand for the vaccine, he said it is important to stress that anyone who continues to Close contact with an infected person can contract smallpox in monkeys.

Like COVID-19 before itThe rollout of a smallpox vaccine to monkeys also shows the importance of global equity, Kilianski said. Monkeypox is endemic in certain parts of Africa – and if vaccines had been easier to access there, a global pandemic might never have occurred.

“It took a few hundred to a few thousand cases in the US for us to start continuing this,” he said. “It really doesn’t have to be.”

Other must-read stories from TIME


Write letter for Jamie Ducharme at jamie.ducharme@time.com.





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