Poor logistics, planning and clunky systems have plagued the introduction of the monkeypox vaccine in America, state officials say — exacerbating the plight already created by the country’s shortage of injections.
Official from 20 states told the New York Times that the way the federal government rolled out shots was inefficient and flawed. Many shipments ended up in the wrong condition. Local officials also had little ability to keep track of when the shots would arrive, making them less able to plan distribution. Sometimes the shots arrived mislabeled or packaged, causing the shots to go bad.
These failures make America’s already scarce access to the shots even worse. According to the most recent figures from the Centers for Disease Control and Prevention (CDC), federal officials have made 1.1 million jabs available to states and delivered 600,000 to local health departments. Experts estimate that for vaccinated men alone who have sex with other men — the highest risk group — it will require at least three million doses.
These problems arise as the monkeypox outbreak in America — the largest in the world so far — continues to develop. The CDC reported 419 new cases Friday, the most recent update, bringing the national number of cases to 11,177. No US deaths have been reported as part of the outbreak.
“Our response is completely inefficient and breaks the backs of the state and local aid workers… [I’ve never] given this level of frustration and stress,” Claire Hannan, executive director of the Association of Immunization Managers, told the Times.
Of the 20 states that have reported problems, more than half are led by Democrats. This indicates that these frustrations are not a political ploy.
The Jynneos vaccine, which is central to the monkey pox response in the country, is manufactured by the Danish company Bavarian Nordic. It was initially targeted at smallpox, but is effective against the tropical virus because they belong to the same family of orthopoxviruses.
The shot is distributed directly from the National Strategic Supply – not through the VTrckS system used to deliver the COVID-19 shot across the country.
Officials have complained that the system used for monkeypox is clunky, inefficient and does not give them enough information about the status of their order.
Currently, each state has five different places where shots are delivered. Local officials are then responsible for its distribution within the states.
For larger states such as California and Texas, transporting shots to areas that are not close to one of five different delivery points can be a problem.
Local authorities also have little knowledge of when the shots will arrive. They don’t get tracking information, which makes it difficult to schedule transportation for them.
Access to the Jynneos vaccine is restricted in the US, so far only 1.1 million doses have been made available and 600,000 have been distributed to local officials (file photo)
“We had no way of tracking vaccine shipments, when they actually shipped or when they would arrive… they just showed up without notice.” Chris Van Deusen, director of media relations at the Texas Department of State Health Services, told the Times.
Sometimes the packages are not clearly labeled that they contain vaccines – which can lead to the injections not being properly stored on arrival.
Jabs also often end up in the wrong place. A shipment of 5,000 doses, destined for Fort Lauderdale, Florida, ended up in Oklahoma, Tennessee and Mississippi before reaching its intended location in the state of Sunshine.
The Times reports that doses delivered to Idaho and Minnesota have become unusable due to poor packaging.
The federal government responded to these complaints by saying that the purpose of the strategic stockpile is to get shots as quickly as possible – rather than using the ordering system used during Covid.
These complaints arise because the federal government plans to review the rollout of the shots. Not logistics, however, but instead by lowering the doses to allow the limited supplies to go further.
Federal officials plan to release doses of the vaccine as low as 0.1 milliliters (ml) — a huge drop from the standard 0.5 ml dose.
They believe that using an intradermal injection — which delivers the vaccine between the layers of skin rather than under the skin’s fat — will ensure that the injection is just as effective.
But there are some questions about whether this is the right move.
In 2015, researchers found that smallpox vaccines were just as effective when given in smaller doses when the injection was done intradermally.
Paul Chaplin, CEO of Bavarian Nordic, published an open letter to Dr. Xavier Becerra, Secretary of the Department of Health and Human Services, and Dr. Robert Califf, Commissioner of the Food and Drug Administration, expressing concern about the lack of data to support the plan.
The Danish pharmaceutical giant is calling for more trials on the effectiveness of the smaller doses before the country revises its vaccine strategy.
Currently, injections are mainly reserved for men who have sex with other men – although some exposed people have received the injection as a precaution.
Meanwhile, the monkey pox outbreak continues to increase in the country. Nearly 6,000 of the 11,177 total cases reported in America so far have come in since August 1.
New York still accounts for the bulk of cases, with 2,295 reports since the virus was first found in the United States in May. A majority of those cases are in New York City.
California (1,945 cases of monkeypox confirmed) and Florida (1,085) are the only other states to have recorded more than 1,000 cases each.