Health officials in North Carolina are considering a change to how the monkeypox vaccine is administered, which could result in five times as many people being vaccinated.
The vaccine, called JYNNEOS, is ordinarily injected into the fat layer underneath the skin in what is known as a subcutaneous injection. On Tuesday, federal health officials OK'd an alternate method where a fractional dose — one-fifth of a full dose — is injected between skin layers in what’s called an intradermal injection.
The two methods are more or less equally effective, according to a clinical trial published in 2015, and using a fraction of a full dose could allow clinics and other providers to stretch a limited supply.
North Carolina’s Department of Health and Human Services is “discussing the logistics” of intradermal injection, agency spokesperson Kelly Haight said in a statement Wednesday. Haight added that DHHS is providing guidance to local clinics and health departments “as more information becomes available.”
In Mecklenburg County, which has emerged as a monkeypox hotspot in North Carolina, health director Raynard Washington on Wednesday called the approval of the alternative method “good news.” But he emphasized more training and planning is necessary before intradermal vaccination for monkeypox can be implemented locally.
“It is a slightly more sophisticated technique and also requires a different type of needle that we don’t typically use because we don’t do very many intradermal vaccinations — or very many intradermal injections at all,” Washington said.
Demand for the monkeypox vaccine in Mecklenburg County has surged in recent weeks as supply continues to be limited. Washington said the county health department’s goal since Monday has been to vaccinate roughly 300 people per day across its two Charlotte clinics, working its way through a waitlist that as of Wednesday morning had roughly 1,770 people.
Monkeypox vaccines can prevent illness or lead to less severe symptoms if given within 14 days of when someone is exposed to monkeypox. JYNNEOS is currently administered as a series of two doses spaced 28 days apart.
Meanwhile, a report released Wednesday by DHHS showed a disparity in who has received monkeypox vaccines in North Carolina.
Less than one-quarter of vaccines administered so far have gone to Black North Carolinians, the report showed, despite Black men making up 70% of the state’s monkeypox cases. Twenty-four percent of the 3,048 vaccines administered have gone to Black residents, according to the report, compared to 67% that have gone to white residents. White men make up 19% of the state’s reported monkeypox cases.
As of Wednesday morning, according to Washington, Mecklenburg County had recorded 64 total confirmed monkeypox cases. DHHS on Wednesday afternoon reported a total of 122 confirmed cases statewide.
