The federal government has shipped more than 336,000 doses of Jynneos monkeypox vaccines—the only shot specifically approved by the Food and Drug Administration to protect against monkeypox—to states and cities across the country since May, with more than 40,000 delivered to some of the hardest hit locations, though reports suggest this supply still could fall substantially short of some jurisdictions’ needs as they confront a spike in cases.

Key Facts

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New York City: As of July 27, New York City—the epicenter of the monkeypox outbreak in the US—had received the largest shipment of monkeypox vaccines out of all jurisdictions, with 45,784 doses delivered, while the state of New York received an additional 16,455 doses, according to to the Department of Health and Human Services (HHS).

California: HHS has shipped 61,271 vaccines to the state of California—which has the second-largest number of monkeypox cases—including 23,982 doses to the city of Los Angeles.

Illinois and Florida—with the third and fifth most infections—have received 28,307 and 36,800 doses respectively.

Some 786,000 more vaccines—which had been stuck in Denmark due to US regulatory hurdles—will be distributed “as soon as possible,” Health and Human Services Secretary Xavier Becerra said last week, which would bring the total number of vaccines distributed in the US to 1.1 million.

But several major cities have said they are still strapped for supplies, and a federal official coordinating the US monkeypox response told the Washington Post the US could soon face a “vaccine cliff,” with the outlet reporting no more vaccines are scheduled to arrive until October.

Big Number

6.9 million. That's how many doses of the Jynneos monkeypox vaccine HHS said the US will have by mid 2023. It ordered five million of those in July.

News Peg

As of Tuesday, the US had 6,326 confirmed cases of monkeypox and orthopoxvirus—the class of viruses that monkeypox belongs to—across every state except Montana and Wyoming, according to to the Centers for Disease Control. Some 25,000 monkeypox cases have been reported in 76 countries around the world that have not historically reported outbreaks as of Tuesday, according to to the CDC. The vast majority of cases have been identified among men who have sex with men.

Surprising Fact

The US only has enough two-dose regimens of Jynneos to vaccinate about one third of an estimated 1.6 million gay and bisexual men at the highest risk of contracting the virus, even taking into account the latest shipment, according to the Post,

Key Background

The US is reliant on a small Danish biotechnology company, Bavarian Nordic, for the Jynneos two-dose regimen vaccine, the only shot approved by the FDA for monkeypox. The US has a larger supply—100 million doses—of ACAM2000, a vaccine approved by FDA for smallpox, which has also been shown to protect against monkeypox, but which cannot be given to people with certain health conditions, including weak immune systems and certain skin conditions like eczema. HHS began shipping doses of Jynneos from the Strategic National Stockpile in May, but cities and states across the country soon sounded alarms of a slow rollout and extremely limited vaccine supply.

What To Watch For

An adapted vaccine allocation strategy. The CDC said in July it would start focusing on jurisdictions with the largest number of cases, while still attempting to prioritize allocation to areas with individuals at high-risk for the disease. Health officials in New York City, San Francisco, Canada and the United Kingdom have decided to delay the second Jynneos vaccine shot to focus on delivering as many first doses to high-risk groups as possible, against the advice of federal health officials, who have argued a two-dose regimen is the best way to protect against the virus. Several cities and states in the US, including New York City and state, California, San Francisco and Illinois have also declared monkeypox a public health emergency, a move they hope will help streamline government responses and boost vaccine access.

US Ordering 2.5 Million More Monkeypox Vaccines Amid Reported Rollout Woes (Forbes)

A One-Dose Monkeypox Vaccine Strategy Could Help Extend Scarce Supplies As US Outbreak Grows (Forbes)

'Not enough shots': US faces 'vaccine cliff' on monkeypox (Washington Post)

Gap between monkeypox vaccine demand, supply dire in hotspot cities (axios)