Technical assistance

United States declares monkeypox a public health emergency

U.S. cases of monkeypox have risen to 6,600, and Thursday’s statement aims to provide improved testing, treatment and vaccination capabilities nationwide.

The Biden administration has declared monkeypox a public health emergency, aiming to ramp up vaccination and treatment capacity, as well as outreach efforts in the face of rising cases nationwide.

Announced at a press briefing by HHS Secretary Xavier Becerra on Thursday, monkeypox cases in the United States have risen to 6,600, an increase from less than 5,000 cases reported last week. A total of 1.1 million Jynneous vaccines have been designated for distribution across the country, of which 602,000 have been delivered to states and jurisdictions, Becerra noted; An additional 150,000 doses will be shipped to arrive at the national strategic stock in September from the previously scheduled October delivery date.

States that have used 90% or more of their current vaccine allocation will be allowed to order additional doses before the next round of orders on August 15.

FDA Commissioner Robert Califf, MD, added that in addition to working closely with the vaccine manufacturer to increase the availability of vaccine doses, a dose-sparing approach is being considered that would allow providers to health care to use an existing 1-dose vial of the vaccine to administer a total of up to 5 separate doses intradermally, as opposed to the current subcutaneous administration.

However, as the current public health emergency declaration falls under Section 319 of the Public Health Services Act, a separate declaration under Section 564 of the Federal Food, Drug and cosmetics would be required to allow intradermal administration of the Jynneous vaccine.

“Intradermal administration has certain advantages, including a better immune response to the vaccine. It is important to know that the overall safety and efficacy profile will not be sacrificed with this approach,” Califf said. “We feel very good about the intradermal approach and in the next few days we will make a final decision on this.”

With regard to treatment, approximately 14,000 doses of tecovirimat (TPOXX) have been deployed, of which approximately 1,700,000 are available in the national strategic stock.

Robert Fenton, the recently appointed White House national monkeypox response coordinator, noted that in addition to increasing vaccination, treatment and testing capacity, the declaration of a public health emergency will allow a better data sharing across jurisdictions to effectively track and contain the outbreak.

A total of 51 jurisdictions have signed data use agreements with the CDC that will make vaccine administration data available, along with detailed testing and hospitalization metrics.

“We have worked to put resources into the hands of those most at risk of contracting monkeypox to enable them to protect themselves directly through social media and through trusted partners and communities across the country,” said CDC Director Rochelle Walensky, MD, MPH. “The public health emergency will mobilize additional stands on the ground to help educate people on the steps they can take to limit their exposure as vaccines become more widely available.”

The statement follows similar actions by health officials in New York, California and Illinois, as well as the World Health Organization, which declared the disease a public health emergency of international concern. its highest warning, July 23.

A total of 1.6 to 1.7 million people are estimated to be most at risk of monkeypox, Walensky said, which includes men who have sex with men (MSM) who are HIV-positive or who are taking pre-exposure prophylaxis (PrEP) to reduce their chance of getting HIV.

While it’s not exclusively a sexually transmitted virus, Demetre Daskalakis, MD, the White House’s deputy national monkeypox response coordinator who also serves as the CDC’s director of HIV prevention, said early signs of the virus show it is spreading faster and differently than seen in past outbreaks.

Daskalakis mentioned several actions he is taking with Fenton to spread essential information about monkeypox symptoms and best practices for prevention to the general public and the LGBTQIA+ community:

  • Provide technical assistance to national and local health departments to develop and scale up non-stigmatizing messaging as they prepare for large gatherings in the weeks and months ahead
  • Develop monkeypox training content for sexually transmitted infections and sexual health providers
  • Provide technical assistance, outreach and training on contact tracing to providers and groups doing this work in jurisdictions across the country
  • Contact provider networks directly to encourage wider use of testing to better understand the scope and transmission of the virus
  • Work with partners to provide up-to-date information on monkeypox prevention and resources, including behaviors or actions that members of the gay, bisexual and other MSM communities can use to limit their risk
  • Listen to community partners, leaders and affected people for insights and feedback on how to improve and expand the response in a community-friendly way

“These are just some of the steps we are taking to aggressively respond to and combat this virus, and work in partnership with individuals, local leaders, public health officials and the LGBTQIA+ community on the ground to across the country,” Daskalakis said.