Cases of monkeypox in the United States are on the decline. nobody knows why

Add to that: there is little past experience with the vaccine, known as Jynneos in the US, being used against this disease. It has only been approved by the United States Food and Drug Administration in 2019, mainly for the prevention of smallpox in case this virus – eradicated from circulation by an earlier vaccine, but preserved in two laboratories – is used as a biological weapon. Jynneos has been studied for safety in humans, but has never been tested for effectiveness against monkeypox in humans; these estimates are based on animal labor. It was never commercially available in the United States, but was instead kept in the National Strategic Stockpile as a safer alternative to this older smallpox vaccine, which can cause dangerous reactions in people whose system immune system is damaged. It was only communicated to the health services that the rare occasions when an infected traveler accidentally brought the virus to the United States.

As a result, “we don’t have any estimates of vaccine efficacy, given the modes of transmission we’re dealing with, which are very different from the modes of transmission we traditionally see,” says Rimoin.

Now, of course, Jynneos is given everywhere, but it is too early to draw conclusions about the degree of immunity created by these injections. The vaccination campaign was uneven: At first, there was so much demand in major coastal cities that men lined up for hours, online dating dashboards filled up in minutes, and for stretching supplies, clinics were withholding second doses that lock in immunity. In response, the White House proposed a dose-sharing strategy that increased availability, but at the cost of a different injection technique that some healthcare workers were unfamiliar with. Today, clinics in cities overwhelmed by the first wave, such as New York, are showing thousands of new appointments regularly and are able to give second doses.

In some areas, indeed, there may be an oversupply. “Our demand has gone down dramatically,” says Philip Huang, a physician and director of the Dallas County Department of Health and Human Services in Texas. “We have empty appointments every day. We give second doses.

Health departments have based their appointment offers and vaccine allocation requests on their idea of ​​the number of men who have sex with men living in their communities, so these open appointments suggest that not everyone eligible for protection may receive it. They may not know they are at risk, they may fear the stigma of moving forward, or they may not know the vaccine is available because overburdened health services do not have the time or staff to craft specific messages to hard-to-reach groups. . “We are still in an active public health emergency, a pandemic response, and our health service personnel are tirednesssays Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials.

And during a briefing at the White House this morning, federal health officials acknowledged that those departments were running out of money to create their campaigns, in some cases transferring money from HIV programs. and STDs to pay for vaccinators and promote education. “Our local jurisdictions have not received any specific resources for monkeypox,” CDC Director Rochelle Walensky said. “This speaks to the need for additional funds.”

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