NYC adopts intradermal monkeypox vaccine strategy


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Center for Infectious Disease Research and Policy

Stephanie Soucheray | News Reporter | CIDRAP News

Beginning today, those getting a monkeypox vaccine in New York City will receive an intradermal injection of the Jynneos vaccine as part of a dose-sparing strategy. The city immediately opened 12,000 vaccine slots upon announcing the decision yesterday.

In other US news, North Carolina reported a pediatric monkeypox case.

Vaccine scarcity in US, globally

“As we continue to see a scarcity of federal supply of monkeypox vaccines, we must adapt to provide a range of options to those who are vaccine-eligible, and to do so in an equitable way,” said New York City Health Commissioner Ashwin Vasan, MD, PhD, in a press statement.

“The Health Department is working to balance these considerations and the concerns we’ve heard from community advocates under supply constraints.”

The city said information about second doses will be released next week.

Intradermal dosing, which stretches one subcutaneous dose to five by injecting the vaccine under the first layer of the skin, is being used to boost the supply of Bavarian Nordic’s vaccine. The company said today it was looking at using technically expired doses of vaccine as another means to increase supply.

Bavarian Nordic CEO Paul Chaplin, PhD, told Reuters the global demand for the vaccine is “exceeding our ability to deliver.”

Chaplin said technically expired doses are being tested to see if they are still effective, and so far as many as half a million doses still have shelf life. He again expressed hesitation about using intradermal dosing, saying the technique is linked to more adverse events at the injection site.

The World Health Organization (WHO) has estimated that 10 million vaccine doses are needed to vaccinate vulnerable men who have sex with men (MSM) around the world. Chaplin said 9 million doses of Jynneos will be produced but will not reach countries until 2023. Roughly 4 million doses are expected to be delivered in the remaining months of 2022.

In related news, the company has also made a pledge to support the Pan American Health Organization’s vaccine efforts in Latin America and the Caribbean, promising vaccines to that region in September.

North Carolina reports pediatric case

The Mecklenburg County Health Department in North Carolina announced the state’s first pediatric case of monkeypox. The state is averaging 11 new monkeypox cases each day, with a total of 261 cases as of yesterday.

Across the country, 476 new monkeypox cases were reported yesterday, lifting the national total to 15,909.

In other global news, both Cuba and Mexico have reported their first fatalities from the virus. The death in Cuba occurred in the country’s first patient, a man from Italy who had previously survived a heart attack. In Mexico, the death occurred in a man with HIV.

The European Centre for Disease Prevention and Control (ECDC) confirmed 16,750 cases in 29 European Union countries. Spain has the most cases, with 6,119, followed by Germany (3,295) and France (2,889).

The ECDC risk assessment still asserts the risk is moderate for those with multiple sex partners and low for the general population.