The U.S. and other countries are scouring their vaccine stockpiles or ordering smallpox shots in a bid to control a global outbreak of the related monkeypox disease, though officials say the effort will be targeted and not a mass drive like the COVID-19 push.
The U.S. is set to release vaccines from the Strategic National Stockpile to protect any high-risk contacts of known cases of monkeypox.
There is a request to release doses of Jynneos, a two-dose vaccine, that is licensed to prevent smallpox and can specifically target monkeypox.
There are 1,000 doses available, though officials expect production to ramp up while officials look to give the shots to those who would benefit the most.
“Those are people who’ve had contact with known monkeypox patients, health care workers, very close personal contact, and those in particular who might be at high risk for severe disease,” said Dr. Jennifer McQuiston, deputy director of the Division of High Consequence Pathogens and Pathology at the Centers for Disease Control and Prevention.
The U.S. confirmed a case of monkeypox in Massachusetts but presumptive cases are popping up in different corners of the country, including two in Utah, two in Florida, one in New York City and one in Washington state.
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The cases are part of unusual clusters of the disease, marked by fevers and a telltale rash, that are arising in countries where the virus isn’t endemic.
Cases are typically found in West and Central Africa and result in humans from contact with rodents. The virus can spread from human to human through close personal contact.
A spreadsheet posted by a University of Oxford researcher documented 270 confirmed or suspected cases of monkeypox around the globe. The outbreak could be linked partly to sexual contact at two recent mass raves in Europe, according to a World Health Organization adviser.
Denmark will begin offering vaccines from the Bavarian Nordic company to contacts of monkeypox patients, the Danish Health Authority told broadcaster DR on Tuesday. The Scandinavian country has two confirmed cases.
Germany said it has ordered 40,000 doses from the same vaccine maker in case its outbreak worsens, though officials said mass vaccination is not planned.
The United Kingdom, meanwhile, said last week it began offering vaccination to health workers who might have been exposed.
Experts said the vaccine can blunt illness if it is given within the first few days after contact with an infected person.
“Using the vaccine as post-exposure prophylaxis is best when it’s early in the incubation period,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.
Even if it is given later, he said, “it may be able to abort or significantly attenuate illness.”
The incubation period of monkeypox is typically from six to 13 days but can range from five to 21 days, according to the WHO.
Dr. Richard Pebody, who leads the high-threat pathogen team at WHO Europe, told Reuters on Monday that mass vaccination is not needed and that good hygiene and safe sexual practices would help control the spread.
Dr. McQuiston said the U.S. has 100 million doses of an older-generation vaccine for smallpox, ACAM2000, but it could produce side effects, so there would need to be a deeper discussion about whether to use it for the monkeypox situation.
A WHO adviser Monday suggested sexual contact at a pair of raves in Spain and Belgium might have spurred the latest outbreaks, which have predominantly affected gay men.
“It’s very possible there was somebody who got infected, developed lesions on the genitals, hands or somewhere else, and then spread it to others when there was sexual or close physical contact,” Dr. David Heymann, an adviser to the WHO, told The Associated Press. “And then there were these international events that seeded the outbreak around the world, into the U.S. and other European countries.”