Smallpox cases in monkeys in the United States are decreasing. No one knows why

Plus: There is little prior experience with the vaccine, known as Jynneos in the US, being used against the disease. It is only approved by the US Food and Drug Administration in 2019, primarily to prevent smallpox in case that virus — eliminated from circulation by a previous vaccine, but kept in two laboratories — was once used as a weapon. Biogas. Jynneos has undergone safety studies in humans but has never been tested for efficacy against monkeypox in humans; Those estimates are based on animal work. It was never marketed in the US, but is instead kept in the Strategic National Stockpile as a safer alternative to the older smallpox vaccine, which can cause adverse reactions. dangerous reactions in people with compromised immune systems. It is only released to the above health departments rare occasion when an infected traveler unwittingly brought the virus into the US.

As a result, “we don’t have an estimate of the effectiveness of the vaccine, based on the modes of transmission we are dealing with, which are very different from the modes of transmission we are used to seeing,” said Rimoin. speak.

Of course, Jynneos is being injected everywhere, but it’s too early to draw conclusions about the level of immunity those shots generate. Immunization campaign uneven: At first, demand in coastal cities was so great that men had to queue for hours, online appointment panels filled up in minutes, and to strain supplies, Clinics withhold a second dose to lock in immunity. . In response, the White House proposed a split-dose strategy to increase availability, albeit at the expense of requiring a different injection technique with which some healthcare workers are unfamiliar. Now, clinics in cities covered by the first wave, such as New York, are posting thousands of new appointments frequent and possibly a second dose.

In fact, in some areas, there may be an oversupply. “Our demand has dropped dramatically,” said Philip Huang, a physician and director of the Dallas County, Texas Department of Health and Human Services. “We have empty appointments every day. We are getting the second dose.”

Health departments base appointment offers and vaccine allocation requests based on their sense of the number of men who have sex with men living in their communities, so those public appointments suggests that all persons eligible for protection may not be admitted. They may not know they are at risk, they may fear stigma when they move on, or they may not know a vaccine is available because health departments are overworked with no time or staff. to draft precise messages for hard-to-reach groups. . “We are still in the midst of an active public health emergency, pandemic response, and our health department staff are tired“Lori Tremmel Freeman, Executive Director of the National Association of County and City Health Officials.

And in a briefing at the White House this morning, federal health officials acknowledged that these departments are running short of cash to create their campaigns that, in some cases, divert money from public health programs. HIV and STD programs to pay staff for immunizations and promote education. “Our local jurisdictions do not receive specific resources for monkeypox,” said CDC Director Rochelle Walensky. “It speaks to the need for additional funds.”

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