October 7, 2022


  • The US is trying to quickly increase its supply of a vaccine used against monkeypox as the rate of cases rises.
  • Today, the White House announced new measures to bring the epidemic under control.
  • One plan is to try “dose maintenance” — dividing one dose among five people. Experts say there’s no evidence yet that it works.

Federal health officials declared a public health emergency for monkeypox on Thursday. The disease has sickened more than 6,610 people across the US since the outbreak was first noticed in mid may.

“There should be no reason why we can’t stay ahead of this,” Health and Human Services Secretary Xavier Becerra said during a call announcing the state of emergency Thursday afternoon.

There is no specific vaccine for monkeypox and no tailored treatment, but there is some evidence that both vaccines and treatments available to fight smallpox – which is a viral relative of smallpox – may work well in the current outbreak . (A widely reported study of about 200 people in Zaire from the mid-1980s suggests that smallpox vaccination may be about 85% protective against monkey pox infections.)

However, the supply of the Jynneos vaccine, which is the only currently approved smallpox vaccine in the US, is particularly tight, and only one Danish manufacturer, Bavarian Nordic, makes the vaccine.

On Thursday, FDA Commissioner Dr. Robert Califf, formulated the idea of ​​”dose sparing” to combat vaccine supply bottlenecks.

“The goal has always been to vaccinate as many people as possible,” he said.

Experts differ on whether a vaccine can work for 5 people

The dose savings for monkeypox would allow clinicians to vaccinate five times as many people with the same amount of vaccine. By injecting a 20 percent dose into the top layer of skin, a provider creates “a pocket where the vaccine goes,” Califf said.

But almost all other vaccines we get today are injected into the muscle (like the COVID-19 vaccine is) or into the fatty layer just above the muscle, by subcutaneous injection (which is how Jynneos is currently given).

Intradermal injections are much less common and require a different approach and technique.

graphic showing depth of injections for current Covid shot (deep) and v near surface suggested



“Clinical Processes for Safer Patient Care” by Glynda Rees Doyle and Jodie Anita McCutcheon



Califf said he is confident that administering the vaccine to the skin will elicit a strong immune response against monkeypox, and that health professionals nationwide are able to do this because the technique is nearly identical to a skin test. PPD for TB.

Dr. Kavita Patel, a primary care physician, he said on Twitter that injecting it this way “may elicit a more effective immune response” and is a strategy already used for some rabies and tuberculosis vaccines, but it is also possible that it “could lead to less efficacy.”

Scientists at the National Institutes of Health hope to answer the question with a new study, but it won’t be completed until November or December at the earliest, as The statistic announced on Thursday.

“If there is evidence of the effectiveness of this, then this would be a strategy to expand the vaccines available,” David Harvey, executive director of the National STD Directors’ Coalition, told Insider.

However, he said, men who have sex with men “deserve” to have “the best vaccine regimen possible.”

“Deficiencies are not acceptable,” he added. “Anything less than the full effectiveness of vaccine doses is against gay men and both men and MSM [men who have sex with men] as second class citizens”.

Mia de Graaf contributed reporting.





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