D.C. shifts monkeypox vaccine policy to focus on first dose



A previous version of this article incorrectly stated the number of monkeypox cases reported in 74 countries as of Friday. There were nearly 17,000 monkeypox cases as of that date. The article has been corrected.

D.C. public health officials are shifting the city’s monkeypox vaccine strategy, using its limited stock of vaccine to give out first doses to the most at-risk population instead of reserving shots for the second dose of the two-shot regimen.

The strategy, announced Monday, means the District will rely on the federal government to provide enough shots for second doses, according to a statement from the D.C. Department of Health.

D.C. officials have administered 5,629 doses of Jynneos, the only vaccine specifically approved to prevent monkeypox, as of Sunday, Patrick Ashley, senior deputy director at the D.C. Department of Health, said in an interview Monday. The regimen’s two doses are scheduled to be delivered at least 28 days apart.

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“Rather than holding back doses, we’re able to get more people vaccinated and contain this quicker,” he said.

Other jurisdictions already have shifted to prioritize first doses, including New York and San Francisco, as well as the United Kingdom and Canada, as officials race to protect at-risk communities.

Ashish Jha, the White House coronavirus response coordinator, was asked about the strategy in a news conference Friday. Jha said more doses are going to be distributed, so “we encourage people to go ahead and use up all their doses as first doses.”

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In another briefing Monday, Jha said the Food and Drug Administration was working quickly to “finalize approval of nearly 800,000 additional doses, and we are getting ready to ship these doses to jurisdictions once FDA has finally approved them.” He added that he hoped the additional doses would be available in the “next few days.”

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As of Monday, 172 cases of monkeypox have been reported in the District, which has more cases per capita than any state. The population hit hardest by monkeypox is men in their early 30s who have sex with men, but D.C. Health Director LaQuandra Nesbitt has stressed that the virus can infect anyone.

The positive cases in D.C. include a child under 1 who was diagnosed in the District but is a U.K. resident traveling with their family. The family traveled extensively inside and outside the United States, and an investigation as to how the child contracted monkeypox is ongoing, Ashley said. The child was never hospitalized and will remain in the District until their isolation is complete.

On Saturday, D.C. Health invited about 5,000 more at-risk people to make free vaccine appointments and will continue to send out invitations as long as supplies are available. The District has received about 13,938 doses, Ashley said.

Federal officials have not said how many doses the District and states will receive in the next shipment, but Ashley said that if the District receives enough vaccine, some people will get their second doses on time.

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“That’s part of the challenge,” he said. “We want as much vaccine as we can get, and we want to get this out as quickly as possible. Timing is very critical. The quicker we can get it into arms, the quicker that we can contain this.”

Ashley said D.C. public health officials considered research that shows a single dose of Jynneos provides as much protection as the single-dose ACAM2000, another vaccine that cannot be used in people with a weakened immune system, for six months or longer.

Health officials will notify anyone who has already received a first dose that their second dose appointment has been temporarily postponed and will reschedule the appointments later — with exceptions for the immunocompromised, whose second shots will not be delayed.

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Monkeypox also has been found elsewhere in the region. Virginia officials report 72 cases as of Monday, and a Centers for Disease Control and Prevention map shows Maryland has 71 cases. Public health officials stress, however, that there are more people infected than the data show because not everyone with symptoms obtains a test.

On Saturday, the World Health Organization declared the international monkeypox outbreak a Public Health Emergency of International Concern, which could make more funding available to combat the virus. Seventy-four countries reported nearly 17,000 cases of monkeypox as of Friday and 19,188 on Tuesday.

Ashley continued to encourage people to be vigilant in monitoring themselves and their sexual partners for any unusual skin conditions and contact their providers if they find anything unusual.

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D.C. residents can preregister for free vaccination appointments at PreventMonkeypox.dc.gov.

Lena H. Sun contributed to this report.

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