The Biden administration has a new plan to help fight the growing monkeypox outbreak with dwindling vaccine supplies. The FDA has expanded its authorization for the vaccine, allowing healthcare providers to inject one-fifth of a typical dose into each patient. Dr. Amesh Adalja, an infectious disease specialist and senior scholar at the Johns Hopkins University Center for Health Security, joined Cheddar News to explain the science behind the new strategy, and how it might help contain the worsening outbreak. "So, there has not been a really smooth or great rollout of this vaccine. But the other point is that we just don't have a lot of it. So we have to be innovative. We have to think about prioritizing the first doses."

Cheddar's News Wrap

U.S. to Stretch Out Supply of Monkeypox Vaccines

the biden administration has a new plan to help fight the growing monkeypox outbreak just this afternoon. The FDA expanded its authorization for the monkey pox vaccine, allowing healthcare providers to inject 1/5 of a typical dose into each patient here. Discussed the strategies. Friend of the show, DR Amos Adalja infectious disease specialist and senior scholar at the JOHns Hopkins University Center for Health Security DR Adalja, welcome to the show, is 1/5 of a vaccine dose as effective as a full dose. What our health experts saying about the strategy? Well, we don't have a lot of data. But what we do know is that when you inject vaccine into the skin versus into a muscle or into the fat, you don't need as much of the material because there's a lot of immune cells there and a lot of reactive ethnicity that occurs when something is put under the skin. So that's where this idea is coming from. And there is some limited data. We obviously would like like to have more, but we're in an emergency situation. I don't think we're going to get much more. Has something like this ever been done before. Or do you think this is a unique effort to try to contain the monkey pox? There has been efforts to use vaccines intradermal E we actually have a flu vaccine that's given intradermal early and we've had to dilute vaccines before. This is something that that is the not something you do routinely. That's something that you do in an emergency situation when you're trying to stretch the supply and that's what's happening right now we don't have enough vaccine to cover the approximately 1.6 million people that are at risk. How has the vaccine rollout for monkeypox been going so far? Dr could this help speed up efforts to get more people vaccinated? This will definitely help get more vaccine into the arms of the at risk. But the whole program has not been very good. We've had a lot of snafus. For example, the websites in new york city to sign up often had technical glitches. We know that there was vaccine that was sitting in Denmark because the FDA has failed to inspect the plant. So there has not been a really smooth or great roll out of this vaccine. But the other point is that we don't, we just don't have a lot of it. So we have to be innovative. We have to think about prioritizing first doses. We have to think about stretching the supply using intradermal injection. And we also have to have first generation smallpox vaccines on the table as well as those only about 600,000 vaccine doses have been delivered to the state so far. But as you well know, the CDC is estimating about 1.61 point seven million people who are at the highest risk for monkey pox. So how does the biden administration plan to get its hands on more vaccines? They have placed orders, but we won't start to see that maybe until 2023. So right now we have to make do with what we have. And I think that's why you're seeing this dilution strategy come to the fore. We also have discussions about using other smallpox vaccines that are more reactive genic but do work and maybe they can be used in certain populations that are counseled about the risks and consent to get that vaccine. But it's going to be tough going to get enough vaccine into people's arms to be able to completely contain this. What can the highest risk people do to better protect themselves from monkey pox doctor. They should first try to get a vaccine as quickly as they can. In lieu of that they should think about for example, decreasing the number of sexual partners they have until they're vaccinated because we know that having a new sexual partner is a risk factor for monkeypox. They should think about exchanging information with sexual partners. So that contact tracing can be easy or done. So it's all about harm reduction right now. And it's going to be difficult because we don't have enough vaccine And that's the best tool that there is. But in lieu of that, maybe some behavioral changes temporarily can help with onward transmission. What should we know? What else should we know about the monkey pox outbreak? I think it's important to recognize that it's not something like COVID-19. It's not something that poses the risk of spreading throughout the population. This is something that requires close contact. It's not very contagious. It's not contagious. During the incubation period we have tested and tried vaccines antivirals that work. It's all about delivering those things competently. So this is not something that I see having pandemic potential. I don't think any pox virus has pandemic potential but it is something we need to contain and that we need to use these tools effectively. To that point how worried should the american public be about monkeypox? I don't think that this is something that they have to worry about infecting everyone in the country or disrupting society. This isn't something that is very contagious. And again as I said we have tools to impact it. What is concerning though is that this should have been easy for the U. S. Government to stop. And the fact that this is happening on the heels of Covid 19 really is concerning. It really tells us that our government is ill equipped to respond to infectious disease emergencies at the pace that's necessary to actually gain ground against them. And I think that's something we really have to come back and revisit because this is not something that the government can continue to do. There's going to be other infectious disease emergencies with less forgiving viruses than monkey pox. Is there a timeline of any sort for this plan to roll out. It's all happening real time. I think this is all going to be happening in the next weeks to months to come. And I think we'll start to see more and more of this discussed. Right now, the secretary of HHS has declared a certain clause and effect of the Food and Drug and Cosmetic Act. So now you'll probably see the FDA think about issuing or issuing an emergency use authorization for the official dilution of the, of the vaccine, dR Adalja infectious disease specialist and senior scholar at the JOHNS Hopkins University Center for Health Security. Always appreciate your time, sir. Thank you.