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Changing how monkeypox vaccine is injected could mean higher doses, but it may not be easy, experts say

Changing how monkeypox vaccine is injected could mean higher doses, but it may not be easy, experts say

 


As part of the Biden administration’s declaration of the monkeypox outbreak in the United States as a public health emergency, it is considering administering the Jynneos vaccine intradermally rather than subcutaneously.

“We are considering an approach to Jynneos’ current dosage that would allow providers to use existing single-dose vials of the vaccine to administer up to five separate doses,” Califf said.

Monkeypox vaccine is currently given subcutaneously. That is, it is delivered under the skin. But with intradermal vaccination, “basically, it stays in the skin. It doesn’t go through the skin,” says Daniel Griffin, M.D., an infectious disease expert at Columbia University.

Influenza and rabies vaccines use smaller intradermal injections, epidemiologist Dr. Jay Varma told CNN in an email.

“The skin has special cells that are very good at helping vaccines stimulate the body’s immune system,” he writes.

The United States waited to order a large stock of monkeypox vaccine preparations.

These cells, called dendritic cells, are highly capable of generating an immune response, Griffin said.

“They live in the skin and are good at teaching the immune system what it needs to respond to,” he said.

“If we can administer the monkeypox vaccine intradermally, we can lower the dose. We just need to prove that we get the same immune response,” he said.

The administration of this vaccine still needs to be studied, Griffin said, but because monkeypox vaccine research and approval is based on antibody responses, not necessarily on efficacy, data on whether it works will be available soon. increase.

Can a doctor give these injections?

While this method can help expand the limited supply of Jynneos, it can also come with challenges.

“It’s a great idea,” Griffin said, given the high demand for the vaccine. I think it’s a great idea on how to make the amount you have much bigger.”

Some lab technicians refuse to draw blood from patients who may have monkeypox, raising concerns about stigma and delays in testing

Dr. William Schaffner, professor of infectious diseases at Vanderbilt University, says these types of injections can be difficult to perform.

“There are challenges with delivering intradermal vaccination. It sounds good, we can deliver more vaccine, but we have to do it right,” he said. There are nurses out there who know how to do this, but the average nurse needs some practice before actually doing this.I don’t trust doctors to do it. They never did it..”

Tuberculosis skin tests use intradermal injections.

“I would like to reach out and reuse a lot of TB nurses because there are so many nurses doing old TB skin tests,” Schaffner said. “They know how to do this and I would expect them to actually administer the vaccine.”

Caliph said “nothing has changed” in the injection method.

“I’m confident about the dosage because it’s routinely done in other situations,” he said.

Dawn O’Connell, assistant secretary for preparedness and response at the U.S. Department of Health and Human Services, said Thursday that 150,000 doses of the Gynneos vaccine are expected to arrive in the U.S. Strategic National Stockpile in September – previously scheduled. The arrival was earlier than the month of October. O’Connell also said that so far he has sent 602,000 cans of his Jynneos to states and jurisdictions.

The US Centers for Disease Control and Prevention estimates that at least 1.5 million people in the United States are eligible for monkeypox vaccination.

CNN’s MJ Lee contributed to this report.

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