Why the threat of weaponized smallpox slowed distribution of monkeypox vaccine

The U.S. will make 786,000 additional monkeypox vaccine doses available to local health departments “as soon as possible” after the Food and Drug Administration approved the shots for distribution, the nation’s top health official said Wednesday.

The vaccine, Jynneos, is made by the Danish biotech company Bavarian Nordic, which is now releasing and shipping the vaccines after initial hesitation. The Danish government originally stated they weren’t going to release them because of the concern of a smallpox terror attack, which is a constant hypothetical threat, according to Rasmussen.

“It’s the reason why we stockpile these vaccines in the first place,” said Dr. Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan. “But I think that’s a really bad argument because that’s a very hypothetical threat that’s never happened over the last 50 years. And this is a crisis that’s happening right now in our midst.”

Monkeypox is described as an Orthopoxvirus, a genus of viruses that also includes smallpox, which is why a smallpox vaccine can be effective against monkeypox and vice versa.

“The vaccine available is a second-generation smallpox vaccine that also is approved for monkeypox,” said Rasmussen. “So as those doses have begun to be released, we do have another 100 million doses stockpiled of another vaccine, called ACAM2000. That’s a first-generation smallpox vaccine, but it’s not approved against monkeypox and it actually has a pretty unfavorable profile for side effects.”

Over the weekend, the World Health Organization (WHO) declared the global monkeypox outbreak is a ‘public health emergency of international concern.’ Researchers hope that the declaration — the agency’s highest alarm — might serve as a wake-up call for countries as they struggle to contain the spread of the virus that causes monkeypox.

“Essentially, [monkeypox] is a rash of these large blisters that become full of pus, and then they turn into scabs and scab over. When the scabs fall off, the person is no longer contagious,” said Rasmussen. “Now, monkeypox is transmitted by actual direct contact with these blisters, or these pustules, or the fluid that’s within them. And you can also contract it either by directly touching somebody’s skin who has these lesions, or you can get it potentially from sharing clothing or bedding with them. But I want to stress that direct contact is thought to be one of the primary mechanisms for transmission in this outbreak.

“Theoretically, you can also potentially contract this by inhaling it. But I don’t want people to get really scared about that,” Rasmussen continued. “Because right now, the epidemiological patterns suggest that is not a major mode of transmission. In this outbreak, the primary mode of transmission is close skin-to-skin contact.”

Monkeypox cases on the rise in western Washington

Monkeypox has been circulating in parts of Africa for decades, but since the first cases were detected outside of Africa in May, more than 16,500 people have suffered from monkeypox in nearly 80 countries that don’t typically see cases of this disease.

A Public Health Emergency has been called by WHO for the seventh time since the system’s creation in 2005. A Public Health Emergency is reserved for events that pose a risk to multiple countries and require a coordinated international response.

Two of those warnings — COVID-19 and polio — are currently in place.

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