Deployment of Monkeypox Vaccine in the United States-Does the Jurisdiction Require All Dose?

The recent outbreak of monkeypox continues to surge in the United States, as it does in many countries around the world.Confirmed Case It rose from just 40 on June 8, 2022 to 4,639 on July 27, 2022 and is distributed in almost every state. If not further contained, there is a significant risk that the current outbreak could become endemic in the United States. One of the best available tools to help mitigate the outbreak is vaccination. however, Limited supply Of the vaccine Report Especially in some jurisdictions, the demand exceeds the supply.

Among the many factors that may affect supply at the local level is whether the jurisdiction requires vaccines assigned to them. Here, we will investigate the requirements of the jurisdiction of JYNNEOS, the preferred monkeypox vaccine, based on what is publicly available. data As of July 22, 2022, all 50 states, Washington DC, and 5 cities (also assigned to regional and tribal entities not described in this analysis). Overall, while most jurisdictions demand full supply, some jurisdictions are well below that mark, questioning how quickly risky populations can be protected. ..

Currently, there are two vaccines available in the United States to prevent monkeypox, JYNNEOS and ACAM2000. JYNNEOS is FDA approved for both monkeypox and smallpox, and ACAM2000 is approved for smallpox, but granted the Extended Access Investigational New Drug (EA-IND) protocol to allow use in monkeypox. It has been. Both vaccines are effective, but JYNNEOS is contraindicated in people with immunodeficiency-related conditions, such as pregnant HIV patients, who have a low risk profile for both patients and healthcare providers, and are less invasive to administer. Not recommended as it is not. , Or, as in the case of ACAM2000, there are other selection criteria. Therefore, JYNNEOS is a priority for deployment in the United States.

Federal government evolves algorithm Based on the current and expected case burden of monkey pox in the jurisdiction and the size of the jurisdiction’s at-risk population defined as men having sex with men with HIV or men with signs of pre-exposure prophylaxis. , Determine the level of allocation to the jurisdiction (PrEP). The jurisdiction should then request the US Centers for Disease Control and Prevention (CDC) to supply the vaccine.

As of July 22, 2022, almost all (97%) of the allocated JYNNEOS vaccine supply has been requested by jurisdictions nationwide. However, this is significantly different, with most jurisdictions requiring full allocation, while subsets require far less than:

• Request rates (number of vaccinations required as part of a jurisdiction allocation) range from a low of only 3% in Arkansas to a high of 115% in Maine.
• The majority of jurisdictions (37) require full vaccination allocation. This includes 11 requests for 100% and 26 requests for more than the allotted amount (see Figure 1).
• The remaining 19 jurisdictions requested less than share, including 10 jurisdictions (WA, MO, KS, GA, NV, MT, SD, OK, KY, and AR) that requested less than 50%.
• Of the 10 people who requested 50% or less, some have a relatively small number of confirmed cases or no confirmed cases and a small population at risk. However, this is not the case in all cases. For example, there are 103 cases in Washington and 312 cases in Georgia (both as of July 27, 2022), and the population of men having sex with HIV-infected people (Georgia) is large or medium. Ranking Five^th Among all state and Washington rankings 18^th), But they demanded 50% and 43% of the assigned dose, respectively.This can be temporary or a timing issue – recent media report Please note that Georgia will soon request a full quota.

Overall, there are currently not enough vaccine doses to meet demand, most jurisdictions have maximized or exceeded quotas, and in some cases still fail to meet demand. However, this is not the case everywhere, and different jurisdictions may have different reasons for not requiring a full quota. In some cases, complete vaccine assignments may be immediately required in states where there are few or few reported cases. For others, other challenges can arise.For example, in Georgia, the state Shown The initial low request rate was due to storage concerns and the time it took to prepare and connect with community partners. In some cases, this may reflect early timing and preparation issues, but it is important to note that speed still plays an important role in curbing the increasing occurrence.

Jurisdiction notification As a result of the third round of vaccination allocation on July 28, 2022, this means more supply, but it may revisit how much to demand to meet local needs. I have. In addition to the number of doses accessed by each jurisdiction, where vaccine access points are, which community partners are included, how civil servants educate people at risk for vaccination, the impact of stigma There are other factors that can promote or complicate vaccine intake, such as. Above all, vaccine communication strategy.Finally, and as we wrote ElsewhereChanges in jurisdiction decisions on how to deal with monkeypox outbreaks, including vaccination strategies, can affect local and national success in controlling them.