As the monkeypox outbreak grows in the United States, demand for the vaccine is outpacing the country’s supply, said Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, at a news conference on Friday.
“We don’t have all the vaccines that we would like to have right now,” she said.
It is not known when the supply crisis will abate. The federal government made an additional 131,000 doses available to states and other jurisdictions on Friday. But the extent of the outbreak remains unclear, in part because diagnostic testing has been slow and limited.
Nearly 1,500 cases have been identified in the United States, mostly in men who have sex with men, and the number is likely to rise in the coming weeks, said Dr. walensky. More than 11,000 cases have been identified in 65 countries worldwide, she added.
“Our chance of getting it under control is closing fast,” said Anne Rimoin, an epidemiologist and monkeypox expert at the University of California, Los Angeles. “There are probably many more cases than we know.”
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 won’t arrive until next year.
A previously ordered 2.5 million doses should arrive by the end of this year, officials said.
“It’s like saying a tanker of water will come next week if the fire breaks out today,” said Gregg Gonsalves, an epidemiologist at the Yale School of Public Health.
Public health experts have criticized the US response to the outbreak as slow and inefficient, beset by some of the same issues that plagued the early months of the Covid-19 pandemic.
Initially, for example, monkey pox testing was extremely limited and any diagnosis had to be confirmed by the CDC, causing delays that could potentially allow the virus to spread undetected and unchecked.
“Now we are in a situation where it will be extremely difficult, with limited supplies of the vaccine and still some problems with testing, to get this under control,” said Dr. Gonsalves.
The CDC has partnered with five commercial testing companies to expand the country’s testing capacity, which now stands at 70,000 samples per week, up from 6,000 at the start of the outbreak.
What you need to know about the Monkeypox virus?
What is monkey pox? Monkeypox is a virus endemic to parts of Central and West Africa. It is similar to smallpox, but less serious. It was discovered in 1958, after outbreaks occurred in monkeys kept for research, according to the Centers for Disease Control and Prevention.
“We have the testing capacity we need and have made it easier to access,” said Dr. walensky.
But health officials should monitor the disease more actively, experts said.
Officials should step into the community and offer testing in locations serving men who have sex with men, as well as communal settings, such as homeless shelters, where the virus could spread, said Dr. Gonsalves.
The monkeypox test involves taking one of the lesions typically associated with the disease, making it difficult to extend the testing to people who don’t have symptoms, said Dr. walensky. “You do have to have a lesion to get a test,” she added.
New tests, including tests that can detect the virus in asymptomatic people, are needed, said Dr. Rimoin, as well as actively monitoring animal populations, which could become reservoirs for the virus.
The virus is unlikely to remain in the networks and communities in which it is currently spreading, she added, and expanding testing is especially important given the limited supply of vaccines.
“The sooner you can identify cases, the better you can isolate them and prevent further transmission,” said Dr. rimoin.
Jynneos, the only vaccine specifically approved by the FDA for monkeypox, is given in two doses, 28 days apart. It is made by Bavarian Nordic, a small company in Denmark, and the worldwide supply is extremely limited.
The United States has purchased a total of nearly seven million doses but has only received 372,000 of them, Dawn O’Connell, the assistant secretary for preparedness and response at the Department of Health and Human Services, said Friday. So far, 156,000 doses have been distributed nationwide, she said.
State health officials can request an alternative vaccine known as ACAM2000, which was developed to prevent smallpox and should also protect against monkeypox, experts say. But that vaccine comes with serious side effects, and the federal government has only provided it to “a few states in relatively modest amounts,” Ms. O’Connell said.
The Food and Drug Administration recently completed an inspection of Bavarian Nordic’s production facility in Denmark and decided whether to approve an additional 780,000 doses.
“We are working hard to complete our review of the required information, pending the hopeful delivery of these doses before the end of July,” said Dr. Peter Marks, a top vaccine regulator at the FDA.
The United States is not considering moving to a single-dose strategy to expand existing offerings, he added. “We are confident that we will have a stock of vaccine to be able to vaccinate with the second dose at the appropriate 28-day interval or close to it,” he said.
States and jurisdictions that see high or increasing cases of monkeypox, and populations believed to be at high risk, will be given priority in allocating new vaccine doses, officials said.
“We work around the clock to increase supply and make sure we reach the riskiest companies,” said Ms. O’Connell.
