Biden administration ramps up monkeypox vaccinations as cases rise

HHS said it has so far received vaccine requests from 32 states and jurisdictions and has shipped more than 9,000 doses, as well as 300 courses of antiviral treatments.

The national strategy marks a dramatic expansion of the government’s efforts to contain the spread of the disease. Initial federal government guidance directed states to only vaccinate individuals with monkeypox and their immediate close contacts, but that approach failed to contain the outbreak as the number of cases continued to rise.

“It’s like we’re expanding the definition of who a contact can be,” said Jennifer McQuiston, associate director of the CDC’s Division of Pathogens and Pathology with Serious Consequences, explaining the new plan. “We are considering contacts [to be] people who may have had recent exposure that would put them at high risk of monkeypox. Whether they were at a party or in a place where monkeypox was known to spread, but we can’t trace them, we encourage them to get vaccinated.”

To date, the CDC has confirmed 306 cases of monkeypox in 28 states and other jurisdictions. California, New York, Florida and Illinois have the highest concentration of cases. The disease, which is now largely circulating among men who have sex with men, causes flu-like symptoms and skin lesions, but patients can receive antiviral drugs and have all recovered so far.

Over 4700 cases worldwide have been reported.

Cities await vaccination

Officials in Los Angeles and New York, which are among the few cities that have already started vaccinating a wider group of at-risk residents in recent days, ahead of CDC leadership, have told POLITICO that they are already waiting for additional requested doses of the vaccine. from the federal government to continue these efforts.

In New York, for example, makeshift vaccination clinic in the Chelsea area Manhattan has injected all 1,000 doses of Jynneos shipped by the federal government. The clinic has now stopped accepting new patients and has requested additional doses, said Michael Lanza, deputy spokesman for the city’s Department of Health and Mental Hygiene.

In Chicago, where the outbreak also occurred, public health officials have begun offering vaccines in places where at-risk people are, such as bathhouses. They also say they will be able to expand coverage as soon as more vaccine stocks are released.

CDC director Rochelle Walensky acknowledged that there are “some restrictions” on Jynneos’ current national supply and that the administration is prioritizing “those who need it most urgently.”

States can also request doses of ACAM2000, an older smallpox vaccine that can be used to treat monkeypox, from a national stockpile of about 100 million doses. It has more side effects than Jynneos and should therefore not be taken by immunocompromised or heart disease patients.

“Driving in the Dark”

The administration’s new strategy also aims to make it easier for doctors to test patients and for people to get tested for monkeypox.

Many epidemiologists and public health advocates say the current number of cases is an underestimate due to difficulties getting tests to the lab and doctors’ ignorance of the disease, which is relatively rare in the US.

To confirm a case of monkeypox, clinicians must send a sample to a laboratory that is part of the CDC Laboratory Response Network. These laboratories can test orthopox viruses such as monkeypox. If a patient tests positive for orthopox, the case is sent to the CDC to determine if it is monkeypox.

This is a relatively quick and easy process for clinicians and medical staff who are familiar with it and who are close to the network lab.

But things get more complicated in large states, rural areas, or where medical staff lacks training. According to clinicians, this leads to undertesting.

“We haven’t had a single case in Michigan yet, but we all, including the Michigan Department of Health and Human Services, know we’re actively testing,” said Gretchen Snoyenbos Newman, assistant professor of infectious diseases at Wayne State University. from Detroit, in an email to POLITICO.

“The testing process was a little unclear and a little cumbersome,” she said, adding that the state health department is actively working to improve it. “Information needs to go out to both providers and the community.”

Last week, HHS said it had begun supplying orthopox tests to five commercial labs, which the agency said would make it easier for doctors to access the tests starting in July.

Meanwhile, the CDC says its nationwide lab network is more than capable of doing the amount of monkeypox testing it needs now. Walensky said on Tuesday that he can now receive and process more than 10,000 tests per week.

But this may overlook the fact that the outbreak is not spreading evenly across the country, some say, and that regional testing labs have different workloads.

“The assumption is that all LRNs are used in the same way — that the Kansas City LRN needs testing just as much as the New York LRN,” said Joseph Osmundson, a biophysicist and assistant professor at New York University. coalition working on the monkeypox outbreak. “And that is clearly wrong.

Without a clear picture of the spread of the virus, Osmundson said it would be difficult for the government to develop an effective strategy to vaccinate the people most at risk.

“We are so far behind in testing that we don’t know who to look for when vaccinating,” he said. “We’re driving in the dark with the headlights off.”