Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said that as the smallpox outbreak broke out in the United States, demand for the vaccine was outstripping the nation’s supply.
“We still don’t have all the vaccines we want at this point,” she said.
When supply would easily be unknown. The federal government provided an additional 131,000 doses to states and other jurisdictions on Friday. But the extent of the outbreak remains unclear, partly because diagnostic testing is slow and limited.
Nearly 1,500 cases have been identified in the United States, mostly in men who have sex with men, and that number is likely to increase in the coming weeks, Dr. Walensky said. Globally, more than 11,000 cases have been identified in 65 countries, she added.
“The window of opportunity to control it is rapidly closing,” said Anne Rimoin, an epidemiologist and monkeypox expert at the University of California, Los Angeles. “There could be a lot more cases out there than we know.”
The Department of Health and Human Services ordered an additional 2.5 million doses of the vaccine, known as Jynneos, on Friday, but those doses are expected to reach customers through next year.
Officials said the 2.5 million doses that had been ordered before would begin reaching customers by the end of the year.
“It’s like saying we have a water tanker coming in next week when the fire is happening today,” said Gregg Gonsalves, an epidemiologist at the Yale School of Public Health.
Public health experts have criticized the US response to the outbreak slow and inefficient, beset by a number of similar problems caused the early months of the Covid-19 pandemic.
For example, initially, smallpox testing in monkeys was very limited, and each diagnosis had to be confirmed by the CDC, creating delays that could allow the virus to spread unseen and unchecked.
Dr Gonsalves said: “We are now in an extremely difficult situation, with a limited supply of the vaccine and there are still some problems in the testing process, to control this.
CDC has partnered with five commercial testing companies to expand the nation’s testing capacity, which now reaches 70,000 samples per week, up from 6,000 at the start of the outbreak.
Things to know about monkeypox virus
What is monkeypox? Monkeypox is a virus endemic to parts of Central and West Africa. It is similar to smallpox, but less severe. It was discovered in 1958, after an outbreak of disease in monkeys kept for research, according to the Centers for Disease Control and Prevention.
“We have the testing capacity we need and have made it easier to access,” says Dr. Walensky.
But health officials should do more active surveillance for the disease, experts say.
Dr Gonsalves said: “Officials should reach out to the public and conduct testing in locations that cater to men who have sex with men, as well as in places of large gatherings, such as shelters. hiding place of the homeless, where the virus can spread.
Testing for monkeypox involves picking up one of the lesions that often accompanies the disease, said Dr. Walensky, making it difficult to expand testing to people who have no symptoms. “You need to have a lesion to be examined,” she adds.
Dr. Rimoin said new tests are needed, including those that can detect the virus in people without symptoms, as well as active surveillance of animal populations where it could become infected. virus reservoir.
The virus is unlikely to survive in the networks and communities in which it is spreading, she added, and expanding testing is particularly important given the limited vaccine supply.
“The faster you can identify cases, the better you can isolate them and prevent further transmission,” said Dr.
Jynneos, the only FDA-approved vaccine specifically for monkeypox, is given in two doses, 28 days apart. It is made by Bavarian Nordic, a small company in Denmark, and its global supply is extremely limited.
The United States has purchased nearly seven million doses in total, but only received 372,000 of them, Dawn O’Connell, assistant secretary of preparedness and response at the Department of Health and Human Services, said Friday. . To date, 156,000 doses have been distributed nationwide, she said.
State health officials could order an alternative vaccine called ACAM2000, which was developed to prevent smallpox and must also provide protection against smallpox in monkeys, experts say. speak. But that vaccine has been associated with serious side effects, and the federal government is only providing it to “a few states in relatively modest amounts,” O’Connell said.
The Food and Drug Administration recently completed an inspection of the Bavarian Nordic manufacturing facility in Denmark and is deciding whether to approve an additional 780,000 doses of the drug manufactured there.
“We are working hard to complete the assessment of the information requested, anticipating the release of these doses hopefully in advance,” said Dr. Peter Marks, a top vaccine administrator at the FDA. end of July”.
The US is not considering switching to a one-dose strategy to stretch existing supplies, he added. “We are confident that we will have a supply of the vaccine so that we can get a second dose of the vaccine at an appropriate 28-day interval or close to that,” he said.
Countries and jurisdictions that are seeing high or increasing numbers of monkeypox cases, and populations considered to be at high risk, will receive priority in dose allocation. new vaccine, officials said.
“We are working around the clock to increase supply and make sure we are reaching those most at risk,” Ms. O’Connell said.
