Clinics across the country will begin offering monkeypox vaccinations to anyone who may have been exposed to the virus, federal health officials said Tuesday.
Until now, immunizations have only been offered to people with some exposure.
The states will receive doses of a safer and newer monkey measles vaccine called Jynneos from federal stocks, based on the number of cases and the proportion of the state’s population at risk of serious illness, officials said at a news briefing.
Public health authorities may also request supplies of an older vaccine developed for smallpox, which is also thought to protect against monkeypox.
The Ministry of Health and Human Services will immediately provide 56,000 doses of the Jynneos vaccine and an additional 240,000 doses in the coming weeks. Another 750,000 doses are expected to be available in the summer and a total of 1.6 million doses by the end of this year.
“This vaccine currently has some supply constraints, and for this reason the current vaccine strategy gives the administration priority in providing it to those who need it most urgently,” said Dr. Rochelle Valenski, director of the Control Centers. and disease prevention.
The older smallpox vaccine, called ACAM2000, has been linked to severe side effects, including death, in people with weakened immune systems, pregnant women and the elderly.
The new vaccination plan drew quick criticism from experts, who said the campaign was too small and slow to make an impact. The longer it takes to control the monkeypox epidemic, the better the chances of the virus becoming established in the United States, especially among men who have sex with men, researchers have warned.
“Many of us are concerned that the window is closing so we can eliminate monkeypox,” said Dr. Celine Gonder, an infectious disease expert and editor-in-chief of public health at Kaiser Health News.
“If we don’t start vaccinating faster and more widely, we will have a very difficult time keeping up,” she said. Ideally, monkeypox tests and vaccines could be offered at LGBTQ Pride events across the country to reach men at high risk of contracting the virus, Dr. Gunder added.
Some experts said the plan was also unfair to men at risk who would not have access to the Jynneos vaccine, especially those who had HIV and could not safely take the older smallpox vaccine.
“There won’t be enough to meet the needs,” said Elizabeth Finley, communications director of the National Coalition of STD Directors. “Furthermore, without better testing capacity, a strategy based on positive case contacts fails.”
It’s also not clear what qualifies as a probable exposure, she added: “Do you have to know someone at the event with a positive test, or do you just say, ‘Oh, I went to a rave and I want to be safe’?”
Many clinicians are worried about the side effects and scars of the older smallpox vaccine, as well as the misinformation and hesitations they can cause, Ms. Finley said. “We had clinicians say there was no way the hell to give someone ACAM2000,” she said.
The Jynneos vaccine, on the other hand, has never been used on this scale, and federal health officials said they would watch for unexpected side effects.
So far, the administration has provided more than 9,000 doses of Jynneos vaccine and 300 courses of antiviral treatment in 32 jurisdictions across the country, officials said on Tuesday.
The European Union has adopted a similar plan, sending 5,300 of its 100,000 doses of Jynneos to Spain, which has the most cases, followed by Portugal, Germany and Belgium. Other Member States will receive doses in July and August.
The number of cases of monkeypox has risen sharply in many European countries and the United States.
As of June 28, there were 306 cases in 27 states and the District of Columbia, up from 156 cases a week earlier. The CDC is activating its emergency operations center to better monitor and respond to the outbreak, Dr. Valenski said.
The reported figures are likely to be underestimated, said Dr. Jay Varma, director of the Cornell Pandemic Prevention and Response Center. “It is quite clear to me, and I think many others, that the epidemic is far larger in scale than our official cases suggest,” he said.
Given the growing number, the available doses will probably not be enough to meet the demand. The Washington Department of Health offered 300 monkey vaccination meetings on Monday; slots filled in less than 15 minutes.
New York, which identified 55 cases of monkeypox as of Tuesday, has 1,000 doses of the Jynneos vaccine. The city’s health department began administering the vaccines to a single clinic in Chelsea, where the clients are mostly wealthy white men who have sex with men.
The city offered the first doses at noon on June 23. Less than two hours later, officials announced that the clinic could no longer receive visitors and had scheduled appointments until June 27. As of Tuesday, the city is still waiting for more vaccine doses to become available.
“It started and then stopped and started without anyone being prepared, and I’m not sure when it will return,” said Celezzo Macofane, an epidemiologist on social media at the FXB Center for Health and Human Rights at Harvard University.
“All this uncertainty is not helping us to cultivate the trust we need to have,” Dr. Macofane said.
Several experts also opposed the location, saying it would be fairer to offer vaccines in clinics frequented by black men with untreated HIV and limited access to health care.
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