Philadelphia’s monkeypox vaccine supply is now part of what was expected

Philadelphia’s plans to expand access to the monkeypox vaccine have been thrown into disarray by the federal government’s decision to give the city only one-fifth of the projected supply.

the city found out late The decision Monday to allocate just 720 vials of the monkeypox vaccine JYNNEOS instead of the expected 3,612. The news has forced health officials to abandon plans to provide vaccines to those at high risk of exposure to the virus, said city health commissioner Cheryl Bettygaard. Priority will continue to be given to those already exposed to the virus, she said. It is unclear when the shipment of 720 vials of vaccine will arrive, but it is expected to arrive soon. Nor do officials know when the city may be allocated more.

Philadelphia vaccine providers should follow the Food and Drug Administration’s strategy to conserve doses by administering doses that are one-fifth the amount recommended. If injected into the top layer of the skin, rather than under the skin, a smaller dose may cause an immune response similar to a full dose. We had hoped to use that dosing strategy along with a larger quota to expand. This means that even with technology that expands HIV, there won’t be enough vaccine for everyone who should be vaccinated. Providers refuse patients trying to get vaccinated against diseases that are not usually fatal, but can be very painful.

“The whole discussion was to scale up the vaccine to get more people vaccinated,” said Betty Gall. “We wanted to move to a larger, more preventive vaccination campaign that we wanted, but we are not in a position to do that.”

On Tuesday, it was unclear whether Philadelphia’s experience reflected national vaccine distribution policies. A spokesperson for the Centers for Disease Control and Prevention said it had not heard of the distribution change and was seeking more information. A local spokesperson for the overseeing Department of Health and Human Services forwarded a request for comment to the department’s national office.

Health departments in Pennsylvania and New Jersey did not respond to questions about whether vaccine quotas had similarly changed.

The city was in the process of introducing a scheme to administer lower doses, and even found a supply of needles needed for intradermal injections. Intracutaneous injections may leave permanent scars, and subcutaneous injections may still be necessary. In other words, the full dose is required.

“Using an intradermal strategy, we don’t have a higher dose than we used to,” Bettigole said. “It may actually be less.”

Bettigor estimates that about 24,000 vaccinations would be needed to provide two doses of the recommended series of vaccines to everyone at high risk of exposure in the city.

As of Monday, Philadelphia had reported 198 cases of monkeypox, up 70 from a week ago. The dose he can administer is just over 1,000. According to CDC data, Philadelphia accounts for nearly half of all monkeypox cases in Pennsylvania. More than 12,600 cases of the virus have been reported nationwide.

Monkeypox is not fatal to anyone in the United States, but it causes rashes and lesions that are painful and contagious and can last up to a month. The virus is transmitted through skin-to-skin contact with these wounds and is not a sexually transmitted disease. was.

Health experts have repeatedly said that to effectively contain monkeypox, it is necessary to vaccinate not only those who have already encountered the virus, but also those who are more likely to be exposed to it than others. The high-risk category includes men over the age of 18 who have recently had multiple or anonymous sexual intercourse with other men, some transgender and non-binary people, and sex workers. . Due to the shortage of vaccines, we cannot count on everyone at risk to be vaccinated.

“Getting a vaccine appointment is like winning the lottery,” said Michael Levasseur, an epidemiologist at Drexel whose research includes health disparities among sexual and gender minority populations. “It’s like the Hunger Games.”

The city’s health department is working on a new vaccine distribution plan and has also notified LGBTQ-focused health care providers, who are controlling vaccine dosages, of reduced supplies, Bettigor said. Proper administration requires special equipment and training, but the city is urging providers to do so as soon as possible.It is also asking federal officials to allocate more vaccine to the city.

“This is far from ideal in the midst of an outbreak,” Bettygall said in a statement Tuesday. “

Staff writer Justin McDaniel contributed to this story.

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