Aug 2, 2022 - Health

Gap between monkeypox vaccine demand, supply dire in hotspot cities

vaccine illustration

Illustration: Brendan Lynch/Axios

In some states that have become hotspots for the monkeypox outbreak, there's a drastic disconnect between the number of doses that local health officials say they need versus what they have been allotted, an Axios Local review of a dozen states found.

Why it matters: Across the nation, health officials worry that the outbreak could become the country's second major public health disaster in as many years if we don't work faster to contain it.

What they’re saying: "It is something that we could contain, but it's gonna require a great deal of effort. I believe we're behind,” says Georges Benjamin, who leads the American Public Health Association.

Context: There are more than 5,000 known monkeypox cases in the U.S. and no deaths, per the CDC.

Urban areas with large LGBTQ+ populations have felt the brunt of the infections so far.

  • “Given that gay and bi men and trans people are the most impacted, it’s sadly becoming clear that we are being left behind once again,” Scott Wiener, a prominent Democratic state lawmaker in California who represents San Francisco, said in a statement.
  • Officials in San Francisco and New York declared a public health emergency last week.

Zoom in: California’s health department told Axios that it estimates needing up to 800,000 doses from the federal government — but so far received under 37,200.

  • In Washington, D.C., health officials say they have put just over 7,000 shots in arms of the two-dose regimen — a relatively high figure. But that still meets only 10% of the city’s projected need, officials said during a town hall meeting last week. Appointments are so hard to come by that some residents go to neighboring counties for shots, reminiscent of the COVID-19 vaccine crunch.

What's happening: States' access to vaccines is limited because the federal government is only able to purchase doses from one company in Denmark. States are able to request how many doses they want from the amount allocated to them.

  • Some jurisdictions, including D.C., Houston, and Chicago have maxed out their shares, according to a Kaiser Family Foundation report.
  • Others, including Georgia, Arkansas, and Montana, have requested less than 50% of their share.

Officials recently announced another purchase of 2.5 million doses of the Jynneos vaccine to add to the national stockpile and said they would immediately release 131,000 doses.

The big picture: Benjamin of the American Public Health Association says if President Biden declares a public health emergency, it would allow the federal government to move funding quicker to states in desperate need.

  • It would also sound the alarm more clearly, prompting more people to protect themselves.

State of play: Many health departments nationwide told Axios they are prioritizing high-risk populations and forgoing at this time a second shot of the two-dose regimen to administer as many first doses as possible.

  • Chicago, a hotspot where cases are up to 419, has received over 4,600 doses. Illinois Governor JB Pritzker declared a state of emergency on Monday to expand resources and coordination efforts.
  • Michigan, another state delaying a second shot, had received nearly 3,400 doses of the vaccine, the health department told Axios, aware that more doses are “not likely to become broadly available in the near-term.” The department said its supply is "limited," but that it couldn't quantify the amount it needs since the outbreak is "evolving." Michigan as of yesterday hadn't yet used up its supply.
  • Arizona has under 3,600 doses and anticipates another shipment near the end of August. “We don’t know how many doses will be available then,” admitted Steve Elliott, a spokesperson for the state health department.

Yes, but: Some places say they are faring better. Dallas officials say their shipment of 5,100 doses should be enough if cases remain low. Texas has 351 confirmed cases.

  • The state of Iowa — with a population of 3.15 million and 10 cases — has enough vaccines to fully inoculate 300 people.

The bottom line: State and local officials don't know when new doses will arrive, but worry that it won't be soon enough.

“Unfortunately, because our federal government failed to act quickly to acquire the vaccine supplies needed to prevent an outbreak, we are now in a public health emergency that is only going to escalate,” said Wiener, the California lawmaker.

Axios Local’s Chelsea Cirruzzo and Cuneyt Dil reported from Washington, D.C.; Nick Bastone in San Francisco; Annalise Frank in Detroit; Jeremy Duda in Phoenix; Karri Peifer in Richmond; Jason Clayworth in Des Moines; and Monica Eng and Justin Kaufmann in Chicago contributed to this report.

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