Advertisement
The move comes after pressure from states that have been urging the government to release more doses of monkeypox vaccine from the strategic national stockpile managed by the Assistant Secretary’s Office for Preparedness and Response at the Department of Health and Human Services. Critics have also accused the United States of not offering enough testing to monitor the spread of the virus, which is believed to be more widespread than current case numbers suggest.
The new plan addresses both. It will release more vaccines in areas with the highest caseloads and expand testing, making testing available at five commercial labs in addition to an existing network of public health labs.
On Tuesday, HHS also activated the CDC’s Emergency Operations Center to give the agency more flexibility and manpower to manage the nation’s monkeypox response.
The new plan will allocate vaccine doses based on case rates in a state and will focus on men who have sex with men and their known partners, as well as anyone who believes they may have been recently exposed to the virus as an anonymous partner.
“If you’re among those who have had a known exposure in the past two weeks, or belong to a group at higher risk for exposure, here’s what we want you to know,” said CDC Director Dr. Rochelle Walensky.
“Vaccinating after exposure, or using vaccines for post-exposure prophylaxis, is thought to reduce your risk of contracting monkeypox virus and then getting sick. Vaccination should be done within two weeks of possible exposure, and the sooner you can get vaccinated after exposure, the better.”
To date, 306 cases of monkeypox have been identified in 28 jurisdictions in the United States. More than 4,700 cases from 49 countries have been reported worldwide, she said.
Currently, 10 states would be considered priority when ordering vaccines.
The plan comes amid gay pride, a month of parties celebrating gender and sexual diversity, and a season that many in the public health community fear will spread the monkeypox virus, which is transmitted through close contact, including sex , just keep heating it up .
Currently, the only people who can receive monkeypox vaccines are those with known exposure, Walenksy said.
Given the large number of contacts and the difficulty of identifying all contacts during the current outbreak, the new strategy will recommend vaccines for those who have known exposure and are contacted by public health, as well as those who have had recent exposure were, but were not identified through contact tracing.
This includes those who have had close physical contact with someone who has been diagnosed with monkeypox, those who know their sexual partner has been diagnosed with monkeypox, and men who have sex with men who have recently had multiple sexual partners in one location, known to have monkeypox or in an area where monkeypox is spreading.
The immunization schedule may require the US to use two different types of vaccines.
The first is a newer, more modern vaccine called Jynneos, made by Danish company Bavarian Nordic. It was evaluated and developed for the treatment of monkeypox infection. The US currently stocks 64,000 doses of this vaccine. The government will make 56,000 of these doses available to states in the first phase of the rollout.
The US has ordered more of that vaccine and the government plans to make 1.25 million more doses of the Jynneos vaccine available in the summer and fall, the government said. There are 300,000 cans that have been saved by the manufacturer and are currently on the way.
But the US doesn’t have enough doses of Jynneos to vaccinate everyone who might want it, so public health officials are also considering using a second, older type of vaccine called ACAM. The ACAM vaccine was developed to treat smallpox. It is given with a two-pronged needle that is repeatedly dipped in the vaccine and used to prick the skin on the upper arm, causing a small sore or “smallpox” to form.
“It’s kind of old-school technology that I basically don’t know of any clinician who actually knows how to do it. So it’s actually very difficult to introduce because you have to train people on a new vaccine methodology.” Jay Varma, Professor and Director of the Cornell Center for Pandemic Prevention and Response in New York City.
The other complication is that the ACAM vaccine uses a live but weakened version of a virus to vaccinate a person.
“It is believed to be unsafe to use in people living with HIV,” Varma said. The primary risk group for monkeypox – men who have sex with men – also have high rates of HIV infection.
On Tuesday, Walensky said the country will adjust its strategy to include more people as more Jynneos vaccine arrives in the United States.
“You know, once we have more vaccines available, obviously we’re going to continue to expand from a post-exposure prophylaxis strategy, ideally to a pre-exposure prophylaxis strategy,” Walensky said.
On Tuesday, public health experts said expansion was important.
“It is critical that we get the vaccine to the vulnerable population and approach vaccine use in a similar way to how we have approached pre-exposure prophylaxis for HIV,” said Dr. Michael Osterholm, who directs the Center for Infectious Disease Research and Policy at the University of Minnesota.
