Government Officials Are Proposing New Methods to Extend the Monkeypox Vaccine Supply to Meet Overwhelming Demand

As of August 12th, 2022, the Centers for Disease Control and Prevention (CDC) reports that there have been 31,799 confirmed cases of monkeypox globally1. This number has jumped substantially since June 2022 when the World Health Organization (WHO) reported 3,040 cases of monkeypox globally2. Due to the increase in cases the WHO declared monkeypox a global health emergency on July 23rd, 2022. Monkeypox is a virus commonly spread by direct contact with a person who has the virus, contact with personal items of a person who has the virus, or by respiratory droplets. The most common symptom of monkeypox is a rash that may be located on just the face, hands, feet, mouth, and/or genitals or it could be all over the body. The rash is often painful or itchy. Other symptoms that could be experienced include fever, headache, and fatigue. Symptoms usually appear within two to three weeks of being exposed. Monkeypox is contagious for an average of two to four weeks until the rash has healed.

Many organizations are recommending people who have been exposed to monkeypox get vaccinated which may aid in lessening the chance of developing the virus or help decrease symptoms. The vaccine is normally a series of two shots that are at least a month apart. The problem is that demand is far outweighing supply at this time. The vaccine shortage has been going on for approximately two months now. Part of the issue is that there is only one producer of the main monkeypox vaccine in the world.

The Biden administration is trying to figure out a way to help with the limited vaccine supply. They are debating about using a different injection method that would help stretch supplies by only using one-fifth of the current dose. This would significantly increase the availability of the vaccine to people in the United States. The thought is that instead of injecting the vaccine into the subcutaneous fat tissue with a full dose, you can instead inject the vaccine intradermally closer to the surface of the skin and use just one-fifth of the originally called for vaccine dosage. This would allow up to five times as many people to be able to get vaccinated. This would help fix the vaccine shortage but the question is whether it will be just as effective. Government officials are basing the assumption that it will still be effective on one research study that was published in 2015 that compared the intradermal injection technique to the standard injection method. The researchers concluded that a similar level of immunity was obtained by using one-fifth the amount of the vaccine using the intradermal injection method instead of the subcutaneous injection method.

The government is basing this solution solely on one research study which was done seven years ago. Considering a theory as strong scientific evidence is usually based on several repeated research studies with well-run experiments that all come to the same conclusion. This is not the case when it comes to this theory because only one research study has been completed.

Other issues that arise are the questions of how many times a vaccine vial can be safely punctured and how long the vaccine will be effective once the vial seal has been punctured several times. Some people are worried about the people giving the vaccines being able to use the intradermal injection method correctly. The intradermal injection method is not a new method but it is not used as frequently as the subcutaneous injection method. Lastly, the US government has a stockpile of monkeypox vaccines that have expired. They are wondering if the expired doses might still be effective and usable. There are many questions and issues that need to be addressed. Government and health officials are working to try to answer these questions but it will take time which is of the essence as the monkeypox virus continues to spread around the world.

Resources

1. Centers for Disease Control and Prevention. (2022, August 4). 2022 Monkeypox Outbreak Global Map. Centers for Disease Control and Prevention. Retrieved August 14, 2022, from https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html
2. World Health Organization. (n.d.). Who director-general’s statement at the press conference following IHR Emergency Committee regarding the multi-country outbreak of Monkeypox — 23 July 2022. World Health Organization. Retrieved July 25, 2022, from https://www.who.int/news-room/speeches/item/who-director-general-s-statement-on-the-press-conference-following-IHR-emergency-committee-regarding-the-multi--country-outbreak-of-monkeypox--23-july-2022
3. Lafraniere, S., & Weiland, N. (2022, August 9). U.S. moves to stretch out monkeypox vaccine supply. The New York Times. Retrieved August 14, 2022, from https://www.nytimes.com/2022/08/08/us/politics/monkeypox-vaccine.html?searchResultPosition=1
4. Lafraniere, S., & Goldstein, J. (2022, August 9). Biden officials change monkeypox dosing regimen to conserve limited supply. The New York Times. Retrieved August 14, 2022, from https://www.nytimes.com/2022/08/09/us/politics/monkeypox-dosing-regimen.html?searchResultPosition=3

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