Florida will delay second shots of monkeypox vaccine to offer more first doses

With more than 1,000 cases of monkeypox in the state, Florida health officials are postponing second doses to offer more first-time shots of the Jynneos vaccine.

“The Department of Health is using all available doses as first doses only. Second doses will be rescheduled once the federal government has increased vaccine supply,” said Nina Levine, a spokesperson for the Department of Health, Broward.

The Jynneos vaccine is approved as a two-dose regimen for monkeypox, given out 28 days apart.

More than 30,000 people in Florida at risk of infection have received their first dose. But as the number of new infections multiply daily, the scramble has been on to get more people vaccinated, particularly in a high-risk category: men who have sex with men.

Most clinics had made appointments for the second Jynneos shot at the time the first was given out. Those appointments will be rescheduled.

South Florida continues to be the hotbed of new infections. On Tuesday, Miami-Dade reported 404 cases, Broward reported 359, while Palm Beach County had 48 cases. That’s more than 800 cases since May.

Experts say one shot should be enough to ward off serious illness from monkeypox — at least temporarily. But preliminary research suggests that people with HIV or other conditions that weaken the immune system may be less protected.

Levine did not say whether those individuals would be prioritized for second shots.

At a news briefing Tuesday, Miami-Dade County’s mayor said that demand for the vaccine is currently much greater than the existing supply, and the county is working to make vaccines available as fast as new supplies are received.

Miami-Dade County will begin offering the monkeypox vaccine to eligible, high-risk residents, in partnership with Nomi Health. A limited number of vaccine appointments will be available to book at miamidade.gov/monkeypox, or by calling 1-833-875-0900.

DOH-Broward will offer additional appointments via the website: vaccineappointmentbroward.com

Even after the U.S. declared monkeypox a public health emergency, the shortfall of monkeypox vaccine doses in the United States is expected to last for months.

Federal officials have ordered nearly seven million doses of Jynneos from the manufacturer, but they may not arrive until winter. So far, the Biden administration has shipped about 600,000 doses to states. Florida has been allocated 109,284 doses as of Tuesday and has been shipped 65,960 of them.

The administration said last week that 800,000 additional doses were being allocated to states, but the distribution could take weeks.

One shot is probably enough to forestall severe symptoms in most people, but no one knows for certain whether going more than 28 days between shots would decrease its effectiveness.

Dr. Aileen Marty, an infectious disease specialist with Florida International University, said those who just have one shot of Jynneos should not consider themselves fully vaccinated — and there is no data to know how protected they are.

“One dose will give them some level of protection but not at the level the vaccine was approved,” Marty said. “This is emergency management of resources, it’s not best science. It’s hope and a prayer.”

In an effort to get more shots out, Dr. Robert Califf, the commissioner of the Food and Drug Administration, said the agency would now authorize shots that contain just one-fifth of the regular dose, delivered between layers of the skin instead of under it. The FDA also is allowing children to receive the vaccine if they are at high risk of monkeypox infection.

No large clinical trial of Jynneos as a monkeypox vaccine in humans has been conducted. Instead, the FDA has relied on measures of antibody responses in small groups of people after immunization with Jynneos and continues to collect data on effectiveness during the current outbreak.

The monkeypox virus mainly spreads through skin-on-skin contact, but it also can transmit through touching linens used by someone with the infection. The vast majority of cases reported have been in men who have sex with men, though health officials have stressed that anyone can catch the virus.

People with monkeypox may experience fever, aches, chills, fatigue and swollen lymph nodes. Many in the outbreak have developed pox-like bumps or lesions on part of their bodies.

Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.