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Biden administration ramps up monkeypox vaccination amid rising cases

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HHS said it has so far received vaccine applications from 32 states and jurisdictions, sending more than 9,000 doses as well as 300 courses of antiviral treatments.

The national strategy marks a dramatic expansion of the government’s efforts to halt the spread of the disease. The federal government’s initial guidelines only instructed states to vaccinate individuals with monkeypox and their direct contacts, an approach that failed to contain the outbreak as the number of cases continued to rise.

“It’s almost like we’re expanding the definition of who a contact might be,” said Jennifer McQuiston, deputy director of CDC’s Division of High Consequence Pathogens and Pathology, explaining the new plan. “We are considering contacts [to be] people who have recently had the type of exposure that puts them at high risk for monkey pox. Whether they attended a party or a location where monkeypox was known to spread, but we cannot trace them, we recommend that they come in for a vaccine.”

To date, the CDC has confirmed 306 cases of monkeypox in 28 states and other jurisdictions. California, New York, Florida and Illinois have the highest concentration of cases. The disease, now largely circulating among men who have sex with men, causes flu-like symptoms and skin lesions, but patients can be given antivirals and they have all recovered so far.

More than 4,700 cases worldwide have been reported.

Cities are waiting for vaccinations

Officials in Los Angeles and New York City, which are among a handful of cities that have already begun vaccinating a larger group of at-risk residents in recent days ahead of CDC guidelines, told POLITICO they have already waited for more requested vaccine doses from the United States. federal government to continue those efforts.

In New York, for example, temporary vaccination clinic in Chelsea district of Manhattan administered all 1,000 doses of Jynneos that the federal government had sent. The clinic has now stopped taking new appointments and has requested more doses, said Michael Lanza, deputy press secretary at the city’s Department of Health and Mental Hygiene.

In Chicago, where there is also an outbreak, public health officials have begun offering vaccines in environments where at-risk individuals go, such as bathhouses. They too say they can achieve more once more vaccines are available.

CDC director Rochelle Walensky acknowledged that there are “some limitations” to Jynneos’ current national offerings and that the government is prioritizing “those who need it most urgently”.

States can also request doses of ACAM2000, an older smallpox vaccine that can be used to treat monkeypox, from the national supply, which has approximately 100 million doses. It has more side effects than Jynneos, and patients who are immunocompromised or have heart disease should not take it.

‘Driving in the dark’

The The administration’s new strategy also aims to make it easier for clinicians to test patients and for people to get tested for monkeypox.

Many epidemiologists and public health advocates say the current number of cases is undervalued, caused by difficulties getting tests to labs and clinicians’ lack of knowledge of a disease that is relatively rare in the U.S.

To confirm a case of monkeypox, clinicians must submit a sample to a lab on the CDC’s Laboratory Response Network. Those labs can test for orthopoxviruses like monkeypox. If a patient tests positive for orthopox, the case is then sent to the CDC to determine if it is monkeypox.

This is a relatively quick and straightforward process for clinicians and medical personnel who are familiar with it and close to a lab in the network.

But it gets more complicated in large states, rural areas, or where medical personnel are untrained. That leads to under-testing, clinicians say.

“We haven’t had any cases in Michigan yet, but we’re all aware that we’re being tested tremendously,” said Gretchen Snoeyenbos Newman, an assistant professor of infectious diseases at Wayne State. University in Detroit, in an email to POLITICO.

“The testing process was somewhat unclear and a bit cumbersome,” she said, adding that the state health department is actively working to improve that. “Information needs to go to providers as well as to the community.”

Last week, HHS said it began shipping orthopox tests to five commercial labs, a move the agency said would make it easier for clinicians to access tests from July.

In the meantime, the CDC says its nationwide lab network has more than enough capacity to handle the number of monkeypox tests now needed. Walensky said Tuesday it can now receive and process more than 10,000 tests per week.

But that may ignore the fact that the outbreak isn’t spreading evenly across the country, some say, and that regional testing labs carry different burdens.

“It assumes that the LRNs are all used equally — that the LRN in Kansas City has the same testing requirement as the LRN in New York City,” said Joseph Osmundson, a biophysicist and assistant professor at New York University who is part of the research group. a coalition working on the monkeypox outbreak. “And that is clearly incorrect.”

Without a clear picture of the spread of the virus, it is difficult for the government to devise an effective strategy for vaccinating the people most at risk, Osmundson said.

“We are so far behind in testing, we don’t know who to focus on for vaccinations,” he said. “We drive in the dark with our headlights off.”

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