There are growing concerns that a monkeypox vaccination campaign could be stalled due to supply shortages.
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Concerns are growing that the window to contain the escalating monkeypox outbreak may be closing as vaccine shortages are leaving some at-risk groups waiting weeks to get vaccinated.
Health experts have warned that failure to get the outbreak under control could result in it spreading to other populations or species.
The UK’s health security agency has said its initial batch of 50,000 vaccines will be used up within the next two weeks, with more doses possibly not getting until September. Meanwhile, other high-tier countries are considering new vaccination methods as supplies dwindle.
Bavarian Nordic — the sole supplier of the only approved monkeypox vaccine — announced Thursday that it has signed a deal with contract manufacturer Grand River Aseptic Manufacturing to help fill orders for its Jynneos vaccine in the United States while maintaining capacity release for other countries. The process is expected to take around three months to get underway.
It follows reports on Wednesday that the Danish pharmaceutical company was no longer confident of being able to meet rising demand, according to Bloomberg.
More than 35,000 cases of monkeypox have so far been confirmed in 92 non-endemic countries since the first case was reported in the UK on May 6. Twelve were fatal.
Cases up 20% in a week
The World Health Organization warned on Wednesday that the virus continues to spread, with cases rising by 20% in the past week alone.
While anyone can be infected with monkeypox, the overwhelming majority of cases to date have been confirmed in gay and bisexual men who have sex with other men.
This has prompted a vaccination campaign, particularly in advanced economies, aimed at protecting those most at risk through either pre-exposure or post-exposure vaccination. But shortages in vaccine supplies and delayed launches are increasing the risk of a broader outbreak, infectious disease experts say.
When it comes to stopping an outbreak, you have a very short window of opportunity. At this point, we see this window of time slowly closing.
Professor Eyel Lesham
Infectious Disease Specialist, Sheba Medical Center
“We know from previous outbreaks that you have a very short window of opportunity when you want to stop an outbreak. At this point, we see that window of opportunity slowly closing,” Professor Eyal Leshem of Israel’s Sheba Medical Center told CNBC on Thursday.
That, in turn, could make the virus spread more easily to other groups or behave differently, Leshem said.
“The more cases we see, the less likely it is to contain this disease. We may be seeing spillovers from the current population to other populations,” he said, naming close contacts and household members, including children and pets, as potentially vulnerable groups.
The first known case in this outbreak of an animal catching monkeypox from humans was reported in Paris earlier this week.
Vaccines “not a silver bullet”
As countries wait for more vaccine shipments, some are now trying alternative means of protecting vulnerable groups.
In a letter leaked to the BBC, the UKHSA said it would be holding some leftover stocks solely for post-exposure patients, meaning other people seeking preventative treatment would have to wait.
Elsewhere, Spain – which has the most reported cases of any non-endemic country after the US – last week asked the European Medicines Agency for permission to give people smaller doses of the vaccine in a bid to further distribute limited supplies.
It follows similar dose-saving plans supported by US health officials, which allow one vaccine vial to give up to five separate shots by injecting it between the skin, not under it.
A relatively short and temporary reduction in the rate of vaccine delivery may not have a large impact.
dr Jake Dunning
Senior Researcher, University of Oxford
Still, WHO’s chief technical officer for monkeypox, Dr. Rosamund Lewis on Wednesday that vaccines should not be viewed as the only form of protection against the virus.
“Vaccines are not a silver bullet,” she said, noting that more data is needed on their effectiveness. Current data comes from a small study from the 1980s that found smallpox vaccines to be 85% effective at preventing monkeypox.
She recommended that those who think they may be at risk “reduce the number of sex partners they have [and] Avoiding group sex or casual sex. “If and when someone gets a vaccine, they should also wait until they have had time to elicit the maximum immune response before having intercourse, usually two weeks,” she added.
dr Jake Dunning, senior researcher at Oxford University’s Pandemic Sciences Institute, agreed, noting that a brief dip in vaccination does not necessarily derail broader efforts to combat the virus.
“If it turns out that, in fact, a large proportion of those most at risk of exposure have already been vaccinated, then a relatively short and temporary reduction in vaccination coverage may not have a large impact on meeting the overall target,” he said.