{"id":24395,"date":"2022-08-15T08:45:42","date_gmt":"2022-08-15T07:45:42","guid":{"rendered":"https:\/\/research.reading.ac.uk\/research-blog\/?p=24395"},"modified":"2023-02-07T12:44:13","modified_gmt":"2023-02-07T12:44:13","slug":"monkeypox-demand-for-vaccines-is-outstripping-supply-this-is-whats-causing-the-shortages","status":"publish","type":"post","link":"https:\/\/research.reading.ac.uk\/research-blog\/2022\/08\/15\/monkeypox-demand-for-vaccines-is-outstripping-supply-this-is-whats-causing-the-shortages\/","title":{"rendered":"Monkeypox: demand for vaccines is outstripping supply \u2013 this is what\u2019s causing the shortages"},"content":{"rendered":"

Over\u00a030,000 cases<\/a>\u00a0of monkeypox have been reported in more than 80 countries worldwide in 2022. Most are in countries that have never previously reported monkeypox. While monkeypox is not as\u00a0transmissible<\/a>\u00a0as many respiratory infections (such as COVID-19), it\u2019s still important to curb the spread.<\/p>\n

\"A<\/p>\n

<\/p>\n

One way to control spread is by\u00a0vaccinating vulnerable people<\/a>. Fortunately, we already have vaccines which are\u00a0very effective<\/a>\u00a0at preventing monkeypox. But as case numbers continue to rise, reports are emerging that\u00a0demand for vaccines<\/a>\u00a0is\u00a0outstripping supply<\/a>\u00a0in many parts of the world currently seeing an outbreak, including\u00a0the US<\/a>,\u00a0UK<\/a>\u00a0and\u00a0Europe<\/a>.<\/p>\n

Vaccine supply<\/h3>\n

There are a number of reasons why we are seeing shortages of the vaccine used to protect against monkeypox. Broadly, it\u2019s due to chronic weaknesses in our global vaccine manufacturing and distribution systems, which make it especially difficult to supply the vaccines needed to protect against new infections and outbreaks.<\/p>\n

The vaccine currently being used to protect against monkeypox is the smallpox vaccine, which works because the monkeypox virus is so closely related to smallpox.<\/p>\n

Until now, the smallpox vaccine has been a niche product because it\u2019s not been needed since smallpox was\u00a0eradicated<\/a>\u00a0in 1980. Pharmaceutical companies can\u2019t afford to manufacture vast numbers of doses just in case, and few governments can justify buying a vaccine that isn\u2019t used. This means the vaccines currently being administered are from\u00a0emergency stockpiles<\/a>\u00a0that were created to respond to an accidental (or deliberate) release of smallpox.<\/p>\n

As such, there are limited stocks and production capacity globally, so demand is rapidly outstripping supply. Even the US, with one of the largest smallpox vaccine stockpiles, recently ordered\u00a02.5 million additional doses<\/a>\u00a0in response to the monkeypox outbreak. But there are reports that the factory in Denmark which makes the world\u2019s only smallpox vaccine approved for monkeypox is\u00a0temporarily closed<\/a>, which may further impact the world\u2019s ability to source more vaccine doses. And unfortunately, transferring production to other facilities is not straightforward.<\/p>\n

One particular problem for vaccine manufacturers is that it\u2019s hard to predict when or where big outbreaks of infections may happen. Of course, there are some infections that we know consistently require a regular supply of vaccines \u2013 such as the influenza virus. But while\u00a01 billion influenza vaccines<\/a>\u00a0are produced globally each year, it still takes\u00a0approximately six months<\/a>\u00a0from picking the most important new strains to manufacturing and rolling out jabs.<\/p>\n

So even with vaccines in high demand, it isn\u2019t simple to manufacture more doses. This is why we are\u00a0still striving<\/a>\u00a0to innovate ways to rapidly produce new vaccines affordably and at a very large scale.<\/p>\n

Vaccines are inherently complicated to make. Because they are made from relatively fragile and complex biological materials (such as a virus), the product has to be exactly right every time. If the formula changes even slightly, it might not work as well \u2013 or even increase the risk of side-effects.<\/p>\n

Adding to this challenge is the fact that different vaccine products may be manufactured by different methods. For example, the equipment needed to produce a viral vaccine (such as the smallpox vaccine used against monkeypox) will be very different to that used to make COVID-19 RNA vaccines. It\u2019s also slow and expensive to test any necessary modifications or improvements that may be needed to make a vaccine safer and more effective.<\/p>\n

Surprisingly, even some simple processes common to all vaccines and other medicines \u2013 such as filling doses into vials for distribution to patients \u2013 still have a mismatch of capacity. Vaccines are usually manufactured in different locations to\u00a0packaging facilities<\/a>, raising logistical hurdles (such as strictly controlled refrigeration requirements) that can further delay distribution. These facilities are used for many different medicines and are usually fully booked years in advance; schedules that are still recovering from COVID-19 disruptions may now be experiencing urgent changes to package the smallpox vaccine from stockpiles.<\/p>\n

It also isn\u2019t just a case of developing new monkeypox vaccines that are easier to manufacture. Even with major recent scientific progress, it would take many months to develop a safe and effective new vaccine. For monkeypox, it\u2019s far quicker and simpler to use the existing smallpox vaccine.<\/p>\n

What can be done?<\/h3>\n

Smallpox vaccine production is likely to be increased to meet demand. But until this happens, many countries will have to make best use of what supplies they can access, and rely on other strategies to help curb the virus\u2019s spread.<\/p>\n

The most effective way to prevent monkeypox causing further harm is by using an integrated, locally led public health response \u2013 vaccines are just one part of this. Testing and contact tracing is vital. If enough infected people in a region can be identified and supported to isolate while they\u2019re infectious, transmission can be blocked.<\/p>\n

Given the vaccine shortages, we expect that people don\u2019t need two vaccine doses to be protected against monkeypox. This is why vaccinating the most at-risk groups with\u00a0one dose now<\/a>, paired with other public health measures, is the most effective strategy for curbing the spread of monkeypox \u2013 especially while vaccine supplies are limited. Second doses can be administered to maximise immunity when supplies do become available.<\/p>\n

The current monkeypox outbreak is yet another reminder of the importance of investing in global health, and ensuring there\u2019s more equal access to vaccines and other medical interventions that can help prevent the spread of harmful diseases.<\/p>\n

Alexander Edwards<\/a> is <\/span>Associate Professor in Biomedical Technology at the University of Reading.<\/strong><\/p>\n

This article is republished from\u00a0The Conversation<\/a>\u00a0under a Creative Commons license.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Over\u00a030,000 cases\u00a0of monkeypox have been reported in more than 80 countries worldwide in 2022. Most are in countries that have never previously reported monkeypox. 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