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Demand for Monkeypox Vaccine Exceeds Supply, C.D.C. Says

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As the outbreak of monkeypox spreads in the United States, vaccine demand is outpacing national supply, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said in a news briefing on Friday.

“We don’t have all the vaccines we need at this point,” she said.

It is unclear when the supply crunch will ease. The federal government made an additional 131,000 doses available in states and other jurisdictions on Friday. However, the scope of occurrence remains unclear due to the slow and limited diagnostic tests.

In the United States, about 1,500 cases have been identified, primarily in men who have sex with men, and this number is likely to increase in the coming weeks, Dr. Warensky said. Globally, more than 11,000 cases have been identified in 65 countries, she added.

Anne Rimoin, an epidemiologist and monkeypox expert at the University of California, Los Angeles, said: “Probably there are far more cases than we are aware of.”

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 not expected to arrive until next year.

Officials said the 2.5 million previously ordered doses should begin to arrive later this year.

Greg Gonzalves, an epidemiologist at the Yale School of Public Health, said:

Public health experts have criticized the U.S. response to the outbreak as slow and inefficient, suffering from some of the same problems that plagued the early months of the Covid-19 pandemic. ..

For example, initially, monkeypox testing was very limited, and each diagnosis had to be confirmed by the CDC, resulting in delays in which the virus was invisible and could spread unchecked.

“Currently, the supply of vaccines is limited and there are still some problems with the tests to control this, which makes it very difficult,” said Dr. Gonzalves.

CDC has expanded its testing capabilities nationwide in collaboration with five commercial testing companies. Currently, there are 70,000 samples per week, from 6,000 when it first occurred.

“We have the necessary testing capabilities and are accessible,” said Dr. Warensky.

However, experts say health authorities should be more active in monitoring the disease.

Authorities need to go out into the community to serve men who have sex with men and to provide tests in collective environments such as homeless shelters where the virus can spread, Dr. Gonzalves said. rice field.

The monkeypox test is usually difficult to wipe off one of the lesions associated with the disease and extend the test to asymptomatic people, Dr. Warensky said. “You need a lesion to get tested,” she added.

Dr. Limoin said new tests are needed, including tests that can detect the virus in asymptomatic people, and active monitoring of animal populations that may be a reservoir of the virus is also needed.

The expansion of testing is especially important given the limited supply of vaccines, she added, that the virus is unlikely to remain in the current prevailing network or community.

“The sooner we can identify the case, the more we can isolate it and prevent further infections,” said Dr. Limoin.

Jynneos, the only vaccine approved by the FDA for monkeypox, is given twice at 28-day intervals. Manufactured by a small Danish company, Bavarian Nordic, its global supply is very limited.

Dawn O’Connell, Assistant Secretary of Preparation and Response for the US Department of Health and Human Services, said on Friday that the United States had purchased nearly 7 million doses in total, of which only 372,000 were received. So far, she said, 156,000 doses have been distributed nationwide.

State health officials can request an alternative vaccine known as ACAM2000, which was developed to prevent smallpox and should also provide protection against monkeypox, experts say. However, the vaccine is associated with serious side effects, and the federal government provides the vaccine only to “a relatively small number of small states,” O’Connell said.

The Food and Drug Administration has recently completed inspections at its Bavarian Nordic manufacturing facility in Denmark and has decided whether to approve an additional 780,000 doses made there.

Dr. Peter Markes, FDA’s top vaccine regulator, said:

He added that the United States is not considering a shift to a single-dose strategy to expand its existing supply. “We are confident that we have a supply of vaccines so that we can have a second vaccination at or near the appropriate 28-day interval,” he said.

States and jurisdictions with high or increasing cases of monkeypox, and populations considered to be at high risk, will be prioritized in the allocation of new vaccine doses, officials said.

“We are working 24 hours a day to increase supply and ensure that we reach the most endangered people,” says O’Connell.

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