DC directs monkeypox vaccine policy to first dose

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An earlier version of this article incorrectly stated the number of cases of monkeypox in 74 countries as of Friday. As of that date, about 17,000 cases of monkeypox were reported. The article has been corrected.

D.C. public health officials are changing the city’s monkeypox vaccine strategy, using limited supplies of the vaccine to give the first doses to the most at-risk population, rather than maintaining a second dose of the two-shot regimen.

The strategy, announced Monday, means the county will rely on the federal government to provide enough ammunition for a second dose, the D.C. Department of Health said in a statement.

DC employees managed 5,629 doses of Ginneos, the only vaccine approved specifically to prevent monkeypox, D.C. Health Department Senior Deputy Director Patrick Ashley said in an interview Monday. At least two doses of the regimen are delivered 28 days difference.

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“Instead of holding back the dose, we can vaccinate more people and cover it faster,” he said.

Other jurisdictions have moved 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’s coronavirus response coordinator, was asked about the strategy at Friday’s press conference. Jha said more doses will be distributed, so “we encourage people to go ahead and use all their doses as the first dose.”

In another briefing on Monday, Jha said the Food and Drug Administration “is working quickly to finalize the approval of about 800,000 additional doses, and we are preparing to send these doses to jurisdictions once the FDA finally approves them.” He added that he hoped additional doses would be available “in the next few days.”

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As of Monday, the district has reported 172 cases of monkeypox, which is more per capita than any other state. The population most affected by monkeypox has been sexually active men over the age of 30, but D.C. Health Director LaQuandra Nesbitt stressed that anyone can be infected with the virus.

Positive cases in DC include a child under the age of 1 who was diagnosed in the district but is a UK resident traveling with his family. The family has traveled extensively in and out of the United States, and the investigation into how the boy contracted monkeypox is ongoing, Ashley said. The boy was never hospitalized and they will remain in the district until the end of the isolation.

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

Federal officials did not say how many doses the county or state will receive in the next shipment, but Ashley said if the county receives enough vaccine, some people will receive a second dose in time.

“That’s part of the problem,” he said. “We want as much vaccine as possible, and we want to get it out as quickly as possible. Time is of the essence. The sooner we can weaponize it, the sooner we can contain this.”

Ashley said D.C. public health officials reviewed six studies that showed a single dose of Ginneos provided as much protection as a single dose of ACAM2000, another vaccine that cannot be used for months or more in people with weakened immune systems.

Health workers will inform everyone who has received their first dose that their second dose has been temporarily postponed and will reschedule appointments for a later date – except for those who are immunocompromised, their second shot is not delayed.

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Monkey pox has also been found elsewhere in the region. Virginia officials reported 72 cases as of Monday, and the Centers for Disease Control and Prevention’s map shows 71 cases in Maryland. Public health officials, however, point out that the data show that many people are infected because not everyone with symptoms gets tested.

The World Health Organization on Saturday declared monkeypox an international public health emergency, which could provide more funding to fight the virus. Seventy-four countries had reported nearly 17,000 cases of monkeypox as of Friday and 19,188 as of Tuesday.

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

DC residents can pre-register for free vaccination appointments at PreventMonkeypox.dc.gov.

Lena H. Sun contributed to this report.

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