White House Revises Monkeypox Vaccine Strategy

WASHINGTON — The White House is rearranging its monkeypox response with a strategy for stretching the supply of vaccines and with new leadership on its task force.

The new strategy announced Tuesday calls for two injections of the vaccine but at only one-fifth the normal potency for each one, which the Biden administration says is nearly as effective as a full dose.

The Food and Drug Administration’s emergency use authorization authorizes health care providers to administer the Jynneos vaccine to anyone at least 18 years old who is at high risk for monkeypox infection.

Ninety-nine percent of the cases are reported in men. About 94% of them are gay.

In addition, the injections would be intradermal, meaning they are administered just under the skin to stimulate the immune system instead of in deeper tissue.

More than 1.6 million Americans are at high risk of infection, according to federal officials. This week, only 440,000 regular doses of the vaccine are available.

The new policy is expected to stretch the vaccine supply to more than 2 million smaller doses, enough to reach all persons most vulnerable to the disease.

Health officials are saying the outlook remains bleak for the spread of monkeypox.

The first monkeypox case was reported in the United States on May 18. By Wednesday, the number of cases was expected to surpass 10,000, according to Centers for Disease Control and Prevention figures.

“So in short, we have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little,” World Health Organization Director-General Tedros Adhanom Ghebreyesus said in a statement urging vigilance against the disease.

New leaders of the task force, Robert Fenton and Demetre Daskalakis, are supposed to manage the federal government’s distribution of the vaccines. They held a press briefing Wednesday afternoon.

Fenton, the National Monkeypox Response coordinator, is a regional administrator for the Federal Emergency Management Agency who oversaw mass vaccinations for the COVID-19 pandemic.

“My goal and our team’s goal and our nation’s goal is to make sure we contain monkeypox,” he said. Increasing vaccine supply is one of the top priorities, he said.

Daskalakis, the National Monkeypox Response deputy coordinator, also directs HIV prevention at the CDC. He discussed the monkeypox policy shift of distributing the Jynneos vaccine in smaller doses than originally planned.

“It does provide us with a very exciting point where we are able to look at very significant increases in the vaccine supply,” Daskalakis said.

Not only is the effectiveness of the one-fifth doses nearly the same as full doses but “serious side effects were uncommon,” he said. Fatigue was the most common side effect.

Among the issues Fenton and Daskalakis are supposed to address is how to coordinate the federal and local response.

Police in several cities are warning about possible hate crimes and retaliation against members of the gay community.

In one example this week, two men in downtown Washington, D.C., were attacked by teenagers who used anti-gay slurs while referring to monkeypox. Washington has one of the nation’s highest rates of monkeypox.

Police report an increase in hate crimes based on sexual orientation in Washington this year. There were 23 reported through June 30, compared with 17 at the same time last year.

Monkeypox is in a family of diseases related to smallpox. Symptoms include a rash that can look like pimples or blisters on the face, inside the mouth and on other parts of the body. The illness typically lasts two to four weeks. It kills about 5% of its victims.

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