Vaccine Disconnect

While waiting on a freeze-dried long shelf-life vaccine to be developed, the United States let its stockpile of liquid monkeypox vaccine languish and expire. By 2017, all 27,993,370 doses in the national Jynneos stockpile had expired, although the US still had a huge stockpile of its other smallpox vaccines (1). While waste per se is shameful, it’s akin to Greek tragedy when the rise in monkeypox cases internationally is associated with lost opportunities to improve millions of people’s lives in sub-Saharan Africa, where smallpox was eradicated in 1980, and vaccinations halted (2).

Many countries now face a growing threat. FDA Commissioner Robert Califf has been quick to revisit strategies discussed in the early days of COVID-19 vaccine availability, when production scarcities predominated. This includes widening the spaces between first and second doses. It also includes using an “intradermal injection”—where the vaccine is injected into the skin—rather than injecting into the layer of fat underneath the skin. Officials believe this smaller dose is able to produce an equal immunologic response, which currently seems unclear. But even if true, each vial contains perhaps enough material for around three times the number of patients, certainly not sufficient for the crisis. At least that’s the feedback from frontline healthcare workers. “We are definitely in what we’re still calling ‘The Hunger Games’ phase of this—where there’s nowhere near enough doses for the demand,” said Dr Mark Del Beccaro, assistant deputy chief for Public Health—Seattle & King County (3).

The new administration route requires using a different syringe and a different needle. This has required tapping into a different supply chain network. In addition, administration under the skin requires a new set of onsite training for staff.

Looking ahead, it’s important to remember our fates are interdependent no matter what continent you call home. It is entirely shortsighted to be disconnected from that simple fact.

References

1. M. Kozlov, “Monkeypox in Africa: The Science the World Ignored,” Nature, June 23, 2022.
2. J. Goldstein, “How the U.S. Let 20 Million Doses of Monkeypox Vaccine Expire,” The New York Times, Aug. 1, 2022
3. W. Stone and P. Huang, “The New U.S. Monkeypox Vaccine Strategy Offers More Doses–and Uncertainty, NPR, Aug. 19, 2022.

About the author

Chris Spivey is the editorial director of Pharmaceutical Technology.

Article details

Pharmaceutical Technology
Vol. 46, No. 9
September 2022
Pages: 10

Citation

When referring to this article, please cite it as C. Spivey, “Vaccine Disconnect,” Pharmaceutical Technology 46 (9) 2022.