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The New US Monkeypox Vaccine Strategy Offers More Doses — and Uncertainty

The New US Monkeypox Vaccine After a rough start it appears that the Biden administration is working to smooth the way through the vaccination program aimed to halt the nation’s rising monkeypox epidemic.

Where can I find a Monkeypox Vaccine Near My Home?

The current effort is based on a novel and untested method of dispersing the previously complete doses to increase the limited vaccine stockpile within the U.S.

The situation is exacerbated by the fact that cases of monkeypox have shot up to over 14,000 within the U.S. – a case more than any other nation anywhere in the world. And yet, many local health authorities are still reporting that they do not have enough vaccines to cover everyone who is more at risk of contracting the disease.

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“We are definitely in what we’re still calling ‘The Hunger Games’ phase of this – where there’s nowhere near enough doses for the demand,” Dr. Mark Del Beccaro, Assistant Chief of Public Health – Seattle & King County.

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Already confronted with the logistical challenges of conducting a vaccine campaign during a public health crisis, health professionals must now tackle a new issue of finding a way to squeeze 5 doses of single-dose bottles.

“It’s great that we can increase the number of people we can vaccinate with the current supply,” says Claire Hannan, head of the Association of Immunization Managers. However, “when you make a change like that, it’s kind of like turning the barge around in the middle of the sea.”

The changes pose challenges to the logistics and messaging – such as training providers and acquiring the right equipment. In addition, there are equity concerns, as the first vaccine data are released and show significant racial differences.

The ability to stretch a finite amount of

It is believed that the U.S. government’s plan to keep the disease at bay is largely based on giving people a JYNNEOS vaccine, which is a two-shot series of vaccines against monkeypox developed by Bavarian Nordic.

However, a sequence of mistakes at the beginning of the response has left the U.S. with a major vaccine shortage. It was difficult for the federal government in approving vaccines and allowed other nations to get ahead of the line, and the distribution process has been a mess for cities and states.

To date this year, so far, the U.S. has shipped around 700,000 vials of monkeypox vaccine to states as well as territories to be distributed. It is the Centers for Disease Control and Prevention have declared that the primary priority is to immunize the 1.7 million individuals most at risk.

A shortage of vaccines due to a shortage of vaccines, the Food and Drug Administration authorized an innovative dosing method in the last week. the vaccine is now available by the technique of an “intradermal injection” – where the vaccine is injected directly into the skin instead of the usual injection into the fat layer beneath the skin.

“This action serves to markedly increase vaccine supply,” stated Dr. Rochelle Walensky, director of the CDC in the CDC’s video that was released on Wednesday. “Intradermal administration of the JYNNEOS vaccine allows vaccine providers to administer a total of up to five separate doses from an existing one-dose vial.”

Federal officials insist that this less dose of vaccine shouldn’t be considered to be a “partial dose” because it’s still capable of producing an identical level of immunologic response to the original procedure of administering it.

The evidence supporting this method is not strong but it has been proven to work to protect against other illnesses.

The idea is based on the possibility that there are numerous immune cells within the skin. “When a vaccine is given into this issue, you can generate a robust immune response using a smaller amount of vaccine,” explained Dr. John Brooks, a medical epidemiologist from the CDC in the clip that cites the findings of a study from 2015 of the vaccine. Brooks said that the technique was tested on other vaccines, including influenza and rabies.

Does one vial equal five doses? It’s not that easy.

It’s not just an issue with the idea of squeezing five doses from what was previously a single dose:

“It’s just mechanically difficult to do,” says Del Beccaro of Seattle & King County. “The federal announcement of five doses per vial was, I think, incredibly optimistic and what we’re seeing in real life is three to four doses per vial.”

Hannan Head of the Association of Immunization Managers has also heard about the same concerns.

Hopefully we will start to see more of the vials yielding five doses, but we’re not seeing that consistently right now,” she says.

It’s not clear if the federal government assumes five doses in each vial as it divides the supply of vaccines, and then sends them for distribution to the health department, according to Del Beccaro.

The bulk of the U.S. vaccine campaign has concentrated on reaching those who are not vaccinated and are at a higher risk of contracting the virus however, shortly, health authorities must be prepared to handle the surge of people who will be returning for their second doses, which will be 28 days after the first.

In the Seattle region, this could mean around 4000 people during the final month of august. It’s still difficult to know what the supply of federal vaccines will be affected, Del Beccaro believes that the current situation suggests that the population will not receive enough vaccine for second shots, while still providing initial shots at a very high level.

The switch requires new supplies and education according to Janna Kerins medical director of the Chicago Department of Public Health. “It means using a different syringe, a different needle,” she says “So it has taken a bit of time to make sure people have the supplies.”

Additionally, providers require technical education on how to inject an injection into the skin. Also “we also need to educate [providers and the communities they serve] on the data that supports this change,” even though there’s little available, she adds.

Feelings of disdain and distrust

The new strategy for dosing can also contribute to an intense sense of injustice within the communities that are most vulnerable to contracting the disease.

The vast majority of U.S. cases are still being discovered within “men who reported recent sexual contact with other men,” CDC director Rochelle Walensky said to reporters on Thursday.

While the data isn’t 100% accurate the data available today suggests an overwhelmingly high percentage of Black and LatinX people belonging to the queer and gay community are suffering from monkeypox and also having difficult vaccinations.

On the 10th of August, the North Carolina health department published findings that 70 percent of all cases were found to be in Black males, however, only 24% of vaccines for monkeypox were given to the Black population.

Chicago is also experiencing the absence of vaccinations among men of different races. 30 percent of the city’s cases have been identified in Latino males, but only 15% of the vaccines have been given to the Latino population, as per Kerins of Chicago. “We have some work to do to try to align the doses of vaccine better with those who are [at risk of] becoming cases,” she says.

National statistics show that lesbian and gay Black as well as Brown communities are suffering from the highest rates of monkeypox. 33 percent of cases occur for people of Hispanics as well as 28% are among the Black.

While no national data have been released regarding vaccinations, the lack of access to those groups is a challenge all over the world, according to Joseph Osmundson, an expert in microbiology at NYU and an activist for queer communities who lives in New York. The new strategy for dosing could help with the current one.

“We expect the data in New York and elsewhere to be similar,” Osmundson states. “What this [dosing strategy] is doing is using a different dosing regimen for those who get the vaccine late – who are more likely to be working class and more likely to be Black and Brown, who have not had the privilege, the ability to access vaccine yet.”

The disparities in access to vaccination have created suspicion and disdain within communities that are racially diverse, according to Kenyon Farrow of the group of advocacy Prep4All.

Farrow believes that public health professionals need to be more thorough to make clear why this approach isn’t inherently inferior. He believes that a perception that he’s encountered online, specifically from gay people of ethnicity the idea the idea that “they let White gay men take all the first full doses. And so we’re now supposed to believe that a fifth of that dose is going to do us just as well.”

Health officials in the Federal government have said they’re working on bridging these gaps.

On Thursday on Thursday, The White House monkeypox response team has announced a pilot program that will provide vaccines to Pride festivals and events , where they will be able to reach gay community, bisexual and queer who are at the highest risk of contracting the disease.

“Many of the events we’re focusing on are events that focus on populations who are overrepresented in this outbreak,” such as Black and Latino people the Dr. Demetre Daskalakis, the deputy coordinator for a national response to monkeypox announced on Thursday in briefings with health officials from the federal government.

“It’s really about positioning messaging and biomedical interventions where people can reach it, and also making sure that we’re going to the right places and talking about the right people.”

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