Can ring vaccination contain monkeypox in the US? | MarketingwithAnoy

Ring vaccination worked against smallpox because a pattern of spread from person to person makes it possible to predict and break chains of infection. The process is straightforward: find the people most at risk of infection and give them the shot. But to take these actions today to stem monkeypox, you need to find cases, you need to identify their likely contacts—and, crucially, you need vaccines to distribute. So far, in the United States, none of these efforts are going well, and epidemiologists, scientists and LGBTQ sexual health experts are skeptical that ring vaccination will succeed.

First, the numbers are rising too fast. “If there were five people, we could do our best to try to do ring vaccination,” says Gregg Gonsalves, assistant professor of epidemiology at the Yale School of Public Health and longtime HIV/AIDS activist. “But now, when you’re dealing with potentially thousands of cases in the United States, trying to contact-trace all of them and vaccinate all of their contacts doesn’t seem like it’s going to happen.”

So any attempt to identify the most vulnerable people, to warn them and get them protected, will have to rely on incomplete information. If ring vaccination represents a fence around an infection risk, “there are huge holes in the fence,” says Steven Thrasher, assistant professor of journalism at Northwestern University and author of a new book on the interplay between viral infections and inequality.

“As far as I can tell, contact tracing has been haphazard, to say the least, and testing was basically unavailable until last week,” agrees Angela Rasmussen, a virologist and associate professor at the Vaccine and Infectious Disease Research Organization-International Vaccine Center at the University of Saskatchewan. “The vaccine is being released in small and large quantities, and it looks like whoever can sign up fast enough can get one. But it’s not ring vaccination. It’s just offering doses to people who might be at risk .”

There’s a lot to unpack here, and plenty of blame to go around. Start with the vaccines. Monkeypox, which spreads to humans from wildlife as well as person-to-person, has been a constant presence in Africa for decades. (Whether the international community should have started worrying about it then, as opposed to just tuning in now, is a discussion worth having.) There are two vaccines that could potentially be used for monkeypox: the old smallpox vaccine , which was stockpiled against potential bioterrorism, and a newer vaccine with fewer side effects. When the US government first noticed the outbreak in late May, it had only 32,000 two-dose course of the safer vaccine available in the strategic national stockpile. A further one million doses were hung up – in bottles and ready for dispatch – at a factory in Denmark, but the Danish Food and Drug Administration had not approved their distribution. Earlier this month, the Department of Health and Human Services placed orders for 5 million doses of the newer vaccine, but most will not arrive until next year.

The limited doses available were sent out to state health departments under an HHS algorithm that calculated a ratio of already detected cases to the number of people thought to be most at risk. It sent most of them to big cities: New York, Los Angeles, San Francisco, Chicago, among others. In New York City, online enrollment for 9,200 vaccination appointments filled in 7 minutes.

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