U.S. Expands Monkeypox Vaccination Strategy

The U.S. is expanding its monkeypox vaccination strategy to include those with a presumed exposure to monkeypox, not just a confirmed exposure, federal officials announced Tuesday evening.

The new strategy takes into account the limited doses of the preferred vaccine, Jynneos, according to CDC Director Rochelle Walensky, MD. The three key groups at high risk for infection who would be eligible for the shot include:

• Those who had close physical contact with someone diagnosed with monkeypox
• Those who know their sexual partner was diagnosed with monkeypox
• Men who have sex with men (MSM) who recently had multiple sex partners in a venue where there was known to be monkeypox or in an area where monkeypox is spreading

“Vaccinating for post-exposure prophylaxis is meant to reduce the risk of infection and becoming sick,” Walensky said during a press briefing. “The sooner you can vaccinate after exposure, the better,” she added, noting that patients should ideally be vaccinated within 2 weeks of exposure.

The changes were announced during a press briefing that brought together officials from the White House, HHS, CDC, and FDA, including White House COVID-19 Response Coordinator Ashish Jha, MD, MPH; Walensky from the CDC; Peter Marks, MD, PhD, director of FDA’s Center for Biologics Evaluation and Research; and the office of the HHS Assistant Secretary for Preparedness and Response (ASPR).

In addition to expanding the vaccination strategy, officials noted that bolstering testing is an additional priority, as is working closely with impacted communities and taking a global approach to curbing the outbreak.

Given the limited vaccine supply, Jynneos will be distributed to areas with the highest transmission and need, using a tiered allocation system, officials said.

To date, more than 9,000 doses of vaccine have been given out, and 56,000 additional doses of Jynneos will be available immediately, according to David Boucher, PhD, director of infectious disease preparedness and response at ASPR.

An additional 240,000 doses of Jynneos — which is manufactured by Bavarian Nordic — will be made available in the coming weeks, Boucher said. More than 750,000 additional doses will become available over the summer, he added, and 500,000 doses are expected by fall, totaling 1.6 million doses available this year.

Jurisdictions can also request the other vaccine, ACAM2000, which is in greater supply but isn’t recommended for everyone, Walensky said. That vaccine has more serious side effects than Jynneos and isn’t indicated for people who are immunocompromised — such as patients with HIV — or who have heart disease.

Jynneos is a two-dose vaccine, given 28 days apart, with maximum protection developing by 2 weeks following the second dose, Walensky said.

As for federal testing efforts, officials said the administration has scaled capacity to 78 labs in 48 states, and began shipping FDA-cleared orthopox virus tests to five major commercial labs last week.

Walensky noted CDC worked with its Laboratory Response Network (LRN) to increase public health testing capacity from about 6,000 tests per week to about 10,000 tests per week.