The Chicago Journal

A new strategy implemented tilts the monkeypox vaccine to varying results

With the increase in monkeypox cases in the United States, there has been a demand for vaccines, and strategies are being implemented with varying results.

Vaccine supply

Vaccination strategies have changed to accommodate the low-dose intradermal approach of Biden administration.

As a result, the change expanded vaccine stocks and met a growing demand for the Jynneos monkeypox vaccine.

Meanwhile, others have reported that the method should allow for five small doses of vaccines; instead, they could only extract four.

The shift

According to Bob Fenton, the White House’s national coordinator for response to monkeypox, more than three-quarters of the jurisdiction moved to the United States to implement the intradermal method of administering the monkeypox vaccine.

“As of today, 75% of jurisdictions are already applying intradermal administration of vaccine, and another 20% are working to move in that direction,” said Fenton.

Claire Hanna, executive director of the Association of Immunization Managers, shared similar results from a recent survey of immunization managers.

Emergency use

In early August, the U.S. Food and Drug Administration issued an emergency use permit that allows health care workers to administer the Jynneos monkeypox vaccine intradermally rather than subcutaneously.

Intradermal administration of the vaccine requires one fifth of the dose for subcutaneous injection, allowing healthcare professionals to receive up to five doses from the standard single-dose vial.

“It’s a little too early to tell how it’s going to help with the supply meeting demand, but I think logically, you use less vaccine for one person,” said Dr. Emily Volk, the president of the College of American Pathologists.

“This is a dose-sparing approach, so it’s going to allow for the doses that we do have to be usable for many more people. So, to me that is very positive and I am actually heartened that the public health community is thinking outside the box.”

“It also buys time to make more vaccine,” she added.

Availability and eligibility of vaccines

The city and county of San Francisco, New York, Fairfax County of Virginia, Cook County of Illinois, and Dallas County of Texas are among the places where a large number of monkeypox cases have been admitting the intradermal administration of the vaccine.

The San Francisco Department of Public Health noted that the U.S. Centers for Disease Control and Prevention and the California Department of Health have provided guidance on switching to the intradermal technique.

After New York adopted its new intradermal vaccination strategy last week, the city announced it would open more than 12,000 new appointments to the public.

Appointments are for people who are eligible for the vaccination and who have not yet received the first dose.

In most places, the vaccine is available to people who are believed to be at risk of exposure to the virus.

Meanwhile, in Virginia last week, vaccine eligibility was expanded to include people of any sexual orientation or gender who have had anonymous or multiple sexual partners in the past two weeks.

In Dallas, vaccination coverage has been extended to adults diagnosed with HIV, chlamydia, gonorrhea, or early syphilis in the past 12 months.


Dr. Sharon Welbel, an infectious disease physician and director of hospital epidemiology and infection control systems at Cook County Health in Illinois, has attended meetings with public health officials in other cities.

Public health officials said they could not get five doses from the vial.

However, Dr. Welbel said that each of their vaccines managed to get five doses per vial.

But in some areas, such as Fairfox County in Virginia, vaccine administrators have not been able to extract all five doses.


According to Dr. Welbel, Chicago had the opportunity to vaccinate more people with the smaller vaccination, leading the city to switch to the intradermal method.

Some healthcare providers practiced with similar weapons, while those who didn’t weren’t allowed to bother vaccinating people until they got used to the new technique.

The new strategy has been successful so far, and Dr. Welbel said Chicago has expanded the population of people eligible for the vaccine, similar to other cities.


Monkeypox strategy shift yields more supply for some, hurdles for others