FDA considers plans to split doses of monkeypox vaccine

SAN FRANCISCO (KPIX) – A local infectious disease expert on Monday said she supports the FDA’s idea of splitting doses of the monkeypox vaccine to get the shots to more people.

The plan is being discussed by health officials as new patients come forward to share the painful experience of recovering from the virus without any prior protection because of limited supply. 

ADDITIONAL INFORMATION ON MONKEYPOX: California Department of Public Health | SF Department of Public Health | Santa Clara County Department of Public Health

“I couldn’t work at all. That first week was really awful,” said David Norman, a San Francisco resident who feels close to leaving isolation after contracting monkeypox last month. “I couldn’t even take calls laying down in bed.”

Norman was unable to get the vaccine because he never had enough time to stand in line and try to get a dose at local clinics unable to meet the demand of people looking for the shot. He did manage to get access to TPOXX, an experimental treatment for monkeypox that can also be difficult to access. 

“I remain frustrated with the relatively sluggish U.S. response,” said infectious disease expert and UCSF professor of medicine  Dr. Monica Gandhi. “Actually, I think this is a really good idea by the FDA.”

The FDA could make a decision this week to use a dose sparing approach where one fifth of a normal dose is injected at a shallower location, or intradermally into the skin. Traditionally, the vaccine is administered subcutaneously, but by injecting it to the top layer of the skin, more cells would have access to it, according to Gandhi. 

This would temporarily help health officials stretch out the limited supply of the vaccine, providing more individuals with some protection. 

“The more immunity we get out there, the more essentially an infection like monkeypox can’t find new people,” Ghandi told KPIX 5 on Monday. “We’ll eventually get the doses for all, we can always go back but spreading immunity across a population will make this thing slow down.”

The San Francisco Department of Public Health will continue its walk-in clinics for the vaccine on Tuesday, but currently does not have any plans to change how it administers the dose. The agency said in a statement it is aware of the method, but needs more research before it can make a decision. 

“We are committed and open to explore every possible avenue that would allow us to get more people vaccinated against monkeypox as soon as possible,” the statement said on Monday. “We would like to see more data and information to justify this approach, and we continue to monitor the science on this topic and will provide an update to the community as appropriate.”  

Gandhi worries about the overall approach in the U.S., which has the most cases in the world but also feels some relief seeing the curve in case count going down in the U.K. 

“This is really showing me what marginalized communities go through and are not being given priority and the same level of care that other groups might be,” Norman told KPIX 5 on Monday. 

Norman said he did not get much help when he first saw initial symptoms of monkeypox including fever, fatigue, and body aches. He went to social media for any assistance to track down the medication needed to treat the virus, while still waiting on test results. 

He says the lesions known as a symptom eventually materialized and he could only get tested once they showed up on his body. He still waited over a week to get results. 

While he remembers three to four days of excruciating pain, he says the TPOXX made a huge difference after one day. He hopes to be back to work next week and says his body has almost completely healed after 11 days of that medication.   

“It was an absolute game changer, as soon as I took my first dose,” he said. “I’ve had several adult hernia surgeries and I would say the pain of this was much, much worse than that. I couldn’t sit, I couldn’t walk standing up straight. As you would imagine, going to the bathroom is a huge ordeal.”