Monkeypox shot shortage feared
Lone manufacturer’s supply spread among 60 nations
As the United States begins a vaccination campaign against monkeypox, concerns are mounting among some experts that the demand may soon far exceed the available supply.
Jynneos, the only vaccine developed for monkeypox, is made by Bavarian Nordic. The small Danish company is expected to send about 2 million doses to the U.S. by the end of the year, but that may hamper the response in other countries, particularly African countries where the virus has been endemic for decades, experts noted.
The U.S. helped Bavarian Nordic develop Jynneos, a safer alternative to older smallpox vaccines, primarily to prevent smallpox in the event of a bioterrorist attack. Instead, Jynneos has become a crucial tool in the race to contain monkeypox.
Because testing has been patchy, the scope of the monkeypox outbreak, and therefore the need for vaccines, is uncertain, said Angela Rasmussen, a research scientist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Canada.
But the current supply “is certainly not enough to vaccinate everybody who’s going to be at risk,” she said.
Roughly 60 countries are grappling with monkeypox cases, and all except the U.S. will need to share available doses — enough for fewer than 2.5 million people — until early 2023.
Bavarian Nordic has “a very small inventory of finished products” already distributed, CEO Paul Chaplin said.
The company has been able to fulfill all of the orders it has so far received, he said. But already, several countries are vaccinating close contacts of patients and anyone else at high risk.
“We still have a window of opportunity to contain the virus,” said Zain Rizvi, who studies access to medicines at the advocacy group Public Citizen. “But that means that everyone who needs access to the vaccine needs it now.”
If the number of cases continues to rise unchecked, he warned, monkeypox may become permanently entrenched in several countries, leading to outbreaks for years to come.
The global count has risen to about 5,500 cases, and at least another 5,000 are under investigation. The U.S. has identified 400 monkeypox cases, but the real number is believed to be much higher.
The outbreak has largely been concentrated among men who have sex with men. An estimated 6 million men who have sex with men live in the U.S. alone.
The U.S. stockpile holds about 56,000 doses that will be distributed immediately. Federal officials expect to receive another 300,000 doses in the next few weeks.
An additional 1.1 million doses have been manufactured for the U.S., but the Food and Drug Administration must inspect them and sign off before they can be released, Chaplin said. The agency is expediting its review, but a spokesperson declined to say how long it might take.
In addition, the U.S. previously had purchased “bulk” vaccine that could be “finished” to produce up to 15 million doses, which would require five months, Chaplin said.
The administration has ordered 2.5 million doses from that stock, the first 500,000 of which are expected to be delivered by the end of the year.
Bavarian Nordic is talking to other manufacturers that could produce more doses, but that, too, generally takes at least four to six months, Chaplin said.
“I want to underscore the absurdity of relying on one single manufacturer to be the global supplier for a vaccine that is needed to curb outbreaks,” Rizvi said. “It’s so stupid that we’re back in this situation.”
Rizvi and others have called for government-owned manufacturing facilities that could be commandeered during outbreaks to churn out vaccines quickly. Plans for such a facility are under consideration, according to a senior administration official with knowledge of the discussions.