Demand for Monkeypox Vaccine Exceeds Supply, C.D.C. Says

As the monkeypox outbreak grows in the United States, demand for the vaccine is outstripping the nation’s supply, Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said at a news briefing on Friday.

“We don’t yet have all the vaccine that we would like in this moment,” she said.

When the supply crunch will ease is unknown. The federal government made another 131,000 doses available to states and other jurisdictions on Friday. But the scope of the outbreak remains unclear, in part because diagnostic testing has been slow and limited.

Nearly 1,500 cases have been identified in the United States, primarily in men who have sex with men, and the figure is likely to rise in the coming weeks, Dr. Walensky said. Globally, more than 11,000 cases have been identified in 65 countries, she added.

“Our window of opportunity to control it is rapidly closing,” said Anne Rimoin, an epidemiologist and monkeypox expert at the University of California, Los Angeles. “There are probably a lot more cases out there than we’re aware of.”

The Department of Health and Human Services ordered an additional 2.5 million doses of the vaccine, known as Jynneos, on Friday, but those doses are not scheduled to arrive until next year.

A previously ordered 2.5 million doses should begin arriving late this year, officials said.

“It’s like saying we have a tanker of water coming next week when the fire is happening today,” said Gregg Gonsalves, an epidemiologist at the Yale School of Public Health.

Public health experts have criticized the U.S. response to the outbreak as slow and inefficient, beset by some of the same problems that plagued the early months of the Covid-19 pandemic.

Initially, for instance, monkeypox testing was extremely limited, and each diagnosis had to be confirmed by the C.D.C., creating delays that might have allowed the virus to spread unseen and unchecked.

“Now we’re in a situation where it’s going to be exceedingly difficult, with limited supplies of the vaccine and still some problems with testing, to get this under control,” Dr. Gonsalves said.

The C.D.C. has teamed up with five commercial testing companies to expand the nation’s testing capacity, which now stands at 70,000 samples per week, up from 6,000 at the beginning of the outbreak.

“We have the capacity for testing that we need and have made it easier to access,” Dr. Walensky said.

But health officials should be doing more active surveillance for the disease, experts said.

Officials should get out into the community and offer testing in venues that serve men who have sex with men, as well as in congregate settings, such as homeless shelters, in which the virus might spread, Dr. Gonsalves said.

The monkeypox test involves swabbing one of the lesions that typically accompany the disease, making it difficult to expand testing to people who do not have symptoms, Dr. Walensky said. “You do need to have a lesion in order to get a test,” she added.

New tests, including those that can detect the virus in asymptomatic people, are needed, Dr. Rimoin said, as is active surveillance in animal populations, which might become reservoirs for the virus.

The virus is unlikely to remain in the networks and communities in which it is currently spreading, she added, and expanding testing is particularly important given the limited vaccine supply.

“The faster you can identify cases, the better you are at isolating them and preventing onward transmission,”…