Facing shortage, Philadelphia rejects CDC guidance to reserve monkeypox vaccine for 2nd doses

A Department of Public Health spokesman points to research saying “a single dose is very protective”
A healthcare worker prepares to administer a vaccine to a person for the prevention of monkeypox.
A healthcare worker prepares to administer a vaccine to a person for the prevention of monkeypox. Photo credit Joe Raedle/Getty Images

PHILADELPHIA (KYW Newsradio) — As monkeypox vaccine shipments slowly arrive to Philadelphia, the city’s Department of Public Health is going against federal guidance to reserve second doses. The city is trying to stretch the available amount for health care providers who are struggling to get shots into arms as the disease spreads.

The CDC and FDA said last week that the standard two-dose course for the Jynneos vaccine should be followed, but a spokesman for the Philadelphia Department of Public Health points to research that says “a single dose is very protective.” The CEO of Bavarian Nordic, the Danish company that makes the vaccine, has endorsed that approach.

As of Thursday, Philadelphia had received just over 2,000 doses. Many who called the health department hotline to try to schedule appointments reported wait times of hours or more, if they were able to get through.

This week, Philadelphia expanded the eligibility criteria in line with federal guidance, to include not only known exposures but also gay and bisexual men who have had multiple or anonymous partners in the past 14 days.

The CDC says the monkeypox vaccine is most effective if given within four days after exposure, but reaching contacts within four days is pretty much impossible for several reasons.

Tests are limited, they take a couple days to come back, and they can’t be done on someone until the monkeypox rash appears, which in itself can take weeks.

“Frustration is absolutely the right word,” said Dusty Latimer, a physician's assistant at the Mazzoni Center in South Philadelphia, which offers health care and other services to the LGBTQ community.

“We have a vaccine that we know is effective,” Latimer added. “We just don't have access to it.”

The city is currently not reserving any vaccines for people to receive second doses, despite the CDC's recommendation to follow the standard two-dose schedule, administered one month apart.

In a 2019 study published in the New England Journal of Medicine, researchers found that antibody levels 14 days after a single dose of the Jynneos vaccine were equivalent to levels produced by the older smallpox vaccine, ACAM2000, which is given as a single dose.

Monkeypox is most often transmitted through skin-to-skin contact. Most cases have been in gay and bisexual men.

The virus is not fatal, but Latimer said lesions are extremely painful, and can cause permanent scarring.

“I have a handful of folks who are just in kind of excruciating pain from, from the localized outbreaks, specifically genital outbreaks,” he said.

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