Monkeypox Response Continues to Face Hurdles after New Federal Guidance

The Food and Drug Administration (FDA) authorised the division of Jynneos vaccine doses into fifths to increase the supply, but state and local health authorities are now confronted with new challenges in responding to Monkeypox. Many authorities are unsure of how to immediately adopt the new strategy.

The Jynneos smallpox vaccine, which is being used to stop Monkeypox in the midst of the ongoing outbreak, has a novel route of administration that the FDA approved last week in order to increase the number of doses now available in the United States. Instead than injecting into the muscle like most vaccines are, the procedure entails injecting one-fifth of the typical dose intradermally, between layers of skin.

The FDA claims that because it was “obvious to all of us that we would not meet current demand with the current supply,” it considered authorising the approach. The choice appears to have also been influenced by a 2015 study that discovered using Jynneos intradermally at a lower dosage elicited a similar immunological response to using it fully when injected into the muscle. The supply of Jynneos dosages would increase five-fold as a result of this recommendation, but many state and municipal health agencies in the regions hardest hit by the Monkeypox outbreak have yet to accept the new approach.

Local governments face a number of obstacles to implementing the new federal guidance, such as staff members who are not trained to deliver intradermal injections, a lack of specialised needles for these injections, and a lack of financing for additional supplies. Without indicating whether it would proceed with the Jynneos vaccines being divided into fifths, a spokesman for the New York City Department of Health and Mental Hygiene said the department was “reviewing the new guidelines.”