Monkeypox Vaccine Shortage
By Zain Rizvi and Aly Bancroft
Jynneos is in shortage around the world. The United Kingdom is nearly out of the monkeypox vaccine.[1] In Belgium, men who have sex with men are only eligible for doses if they can document recent sexually transmitted infections.[2] The director of the Africa CDC has decried vaccine inequality. “Let us get vaccines onto the continent,” he said recently.[3] The United States has begun administering vaccines intradermally to stretch out supply, even as questions about efficacy remain.
Public Citizen reviewed public records to track monkeypox vaccine stocks. Our analysis is significantly limited by a lack of transparency. Granular information about vaccine deliveries, orders, and stocks is kept secret, and many deals are not made public. Nonetheless, based on publicly available information, we estimate that:
- The U.S. has 36 percent of global monkeypox cases, but nearly 80 percent of the global supply.
- African countries where monkeypox is endemic, including the Democratic Republic of Congo, neither have access to doses nor orders secured, despite recording multiple deaths.
- No doses are available yet in Brazil, even as the country has reported more than one in twelve cases globally.[4]
- For every monkeypox case reported in the U.S., over 60 doses are available. For every monkeypox case reported in Spain, 2 doses are available. The U.S. has 22 times more doses than the E.U. and the U.K.
Table 1: Monkeypox cases and vaccines obtained by select jurisdictions
| Country/Region | Cases | Doses obtained [5] | Doses ordered [6] | Ratio of cases to doses obtained |
|---|---|---|---|---|
| United States | 16,602 | 1,100,000 | 7,000,000 [7] | 1:66 |
| Australia | 102 | 22,000 | 450,000 | 1:216 |
| Belgium | 671 [8] | 3,040 [9] | 30,000 | 1:5 |
| Brazil | 3,984 [10] | 0 | 50,000 [11] | Undefined |
| Colombia | 273 [12] | 0 | 5,600 [13] | Undefined |
| Canada | 1,191 | 99,000 | 750,000 | 1:83 |
| DRC | 163 | 0 | 0 | Undefined |
| European Union | 16,750 | 50,000 | 163,620 | 1:3 |
| France | 2,889 [14] | 42,000 | 250,000 | 1:15 |
| Germany | 3,350 [15] | 50,000 | 240,000 | 1:15 |
| Ghana | 47 | 0 | 0 | Undefined |
| Israel | 215 | 5,600 | 10,000 | 1:26 |
| Kuwait | 0 | Unknown | 5,000 | N/A |
| Latin America and Caribbean (PAHO) [16] | 6,396 | 0 | 100,000 [17] | Undefined |
| Nigeria | 157 | 0 | 0 | Undefined |
| UK | 3,207 | 50,000 | 150,000 | 1:16 |
| Undisclosed European Country | Unknown | Unknown | 1,500,000 | N/A |
| South Korea | 1 | Unknown | 10,000 [18] | N/A |
| Spain | 6,284 | 12,000 [19] | 200 | 1:2 |
| Switzerland | 424 | Unknown | 40,000 | N/A |
| Sub-total [20] | 45,255 | 1,418,600 | 10,698,820 |
The U.S. government has the world’s largest stockpile of monkeypox vaccine, which includes stored vaccine bulk that could be converted to more than 10 million doses. Using the Defense Production Act, the government should rapidly convert the bulk into finished doses to help surge global supply. It should also work with partners to transfer technology and help shore up global vaccine production, including in Africa. Last month, the director of the Africa CDC described the stakes for monkeypox: “The solutions need to be global in nature,” he said. “If we’re not safe, the rest of the world is not safe.”
[1]Monkeypox Vaccine in Short Supply But Outbreak Easing, Says UK, Bloomberg, https://www.bloomberg.com/news/articles/2022-08-15/monkeypox-vaccine-in-short-supply-but-outbreak-easing-says-uk (noting new deliveries not expected until late September)
[2]Anger and anxiety stalk EU’s monkeypox vaccine lottery, https://www.politico.eu/article/monkeypox-europe-relives-the-mistakes-of-covid-and-the-stigma-of-hiv/
[3] Africa’s alone in monkeypox deaths but has no vaccine doses https://apnews.com/article/covid-health-pandemics-public-africa-548c20d2a78c53e0b9ba0fb7cbc0373e
[4] Deliveries of some doses are expected sometime in September.
[5] The number of doses assumes that injections will be administered subcutaneously, not intradermally. This number can also be considered to represent the number of vials.
[6] For members of the EU, this column only includes direct national purchases. For Canada, this includes optional orders.
[7] Nearly seven million.
[8] Belgium is included in the EU case count.
[9] We counted these as part of the EU bloc purchase.
[10] Brazil is included in the PAHO case count.
[11] Brazil is procuring doses through the PAHO joint purchase and included in the 100,000 figure.
[12] Colombia is included in the PAHO case count and included in the 100,000 figure.
[13] Colombia is procuring doses through the PAHO joint purchase.
[14] France is included in the EU case count.
[15] Germany is included in the EU case count.
[16] Data from the United States and Canada are excluded from the figures in this row.
[17] Excluding Brazil and Colombia, the total is 44,000.
[18] Not confirmed.
[19] We counted these as part of the EU bloc purchase.
[20] As of August 24, the total MPX cases in the 2022 outbreak is 45,535, according to CDC. To avoid double-counting, the figures in the table corresponding to a particular jurisdiction were only used once.