Feds propose new dosing strategy for monkeypox vaccine: Shots

The monkeypox epidemic is growing in the United States and vaccines remain rare.

Patrick Semansky/AP

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Patrick Semansky/AP

Feds propose new dosing strategy for monkeypox vaccine: Shots

The monkeypox epidemic is growing in the United States and vaccines remain rare.

Patrick Semansky/AP

With the monkeypox vaccine still in short supply, the Biden administration is changing how the vaccine is administered to expand its limited number of doses.

On Tuesday afternoon, federal health officials announced their decision to allow the JYNNEOS vaccine to be administered between the layers of skin — known as an intradermal injection — rather than into the fat as is currently done. .

By delivering the injections in this way, only one-fifth of the full dose is needed for each person.

To effect the change, the Food and Drug Administration issued an emergency use authorization to authorize the new vaccine dosing and injection strategy. (This follows last week’s decision by the US Department of Health and Human Services to declare monkeypox a public health emergency, and an additional declaration today.)

“Over the past few weeks, the monkeypox virus has continued to spread at a rate that clearly shows that our current vaccine supply will not meet current demand,” said FDA Commissioner Dr. Robert M. Califf. , in a press release.

Currently, US stocks of monkeypox vaccine are insufficient to contain the growing epidemic. So far, there have been about 9,000 confirmed cases of monkeypox in the United States, and that’s likely an undercount given ongoing testing challenges.

Even with the switch, a person will still need to receive two doses of the vaccine, each given four weeks apart.

During this current epidemic, the vast majority of cases in the United States are occurring in gay and gay sex networks, primarily among men who have sex with men. Most cases have been traced to male-to-male sexual contact, according to the latest data from the Centers for Disease Control and Prevention.

About 1.6 to 1.7 million people are considered most at risk of contracting the disease, but only about 1.1 million doses of the vaccine are available in the United States – enough to cover less than half of this population with the two-dose regimen – due to expiring vaccine supplies and delays in ordering replacements.

“By simply changing the application technique, you triple, quadruple your supply of available vaccines,” says Dr. Jon Andrus, an infectious disease specialist at George Washington University. “So it makes sense to move forward.”

The skin is home to a number of immune cells that trigger a potentially better immune response, he says.

But this alternative approach has its challenges: it is more difficult to administer a vaccine between the layers of skin and requires special training. Although this method worked for poliomyelitis and yellow fever, the evidence that it will work for monkeypox is based on a single 2015 study.

“Right now, we need a lot of vaccines in a very short period of time if we want to come face to face with this virus,” says Anne Rimoin, epidemiologist at UCLA. “And these vaccines are probably going to be very effective.”

Rimoin adds that we need to remember that this is a global epidemic. The idea that something happening in a distant part of the world doesn’t affect us here “needs to be dispelled as soon as possible,” she says. “We really need to strengthen our health systems [and] our surveillance systems locally, but also by helping our partners in low-resource settings to be able to do so globally. »


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