As Monkeypox Spread in New York, 300,000 Vaccine Doses Sat in Denmark

On the Thursday before Pride Weekend last month, hundreds of men dropped what they were doing and raced to a city-run health clinic in Manhattan. Finally, more than a month after monkeypox appeared in New York City, a vaccine was being made available to sexually active gay and bisexual men, among whom the virus was rapidly spreading.

But there was a catch: There were only 1,000 doses available. Within two hours, the only clinic offering the shots began turning people away.

At that same moment, some 300,000 doses of a ready-to-use vaccine owned by the United States sat in a facility in Denmark. American officials had waited weeks as the virus spread in New York and beyond before deciding to ship those doses to the United States.

Even then, there was little apparent urgency: The doses were flown piecemeal, arriving over the span of two weeks. Many didn’t arrive until July, more than six weeks after the first case was identified in New York City.

By holding back the doses, an early opportunity to contain or slow the largest monkeypox outbreak in the country appears to have slipped by. On Saturday, the World Health Organization declared monkeypox a global health emergency. At least 16,000 cases have been reported around the world, with about 3,000 in the United States. Infections in New York City make up nearly a third of the national case count.

Limited testing means those numbers are likely a significant undercount.

The federal response to monkeypox, including the limited testing capacity, has echoes of how public health authorities initially mismanaged Covid-19.

With monkeypox, however, the federal government had a powerful tool to slow the spread from the start: an effective vaccine.

Yet the government was slow to deploy the vaccine, which was originally developed and stockpiled for use against smallpox, activists say.

“The U.S. government intentionally de-prioritized gay men’s health in the midst of an out-of-control outbreak because of a potential bioterrorist threat that does not currently exist,” said James Krellenstein, a Brooklyn-based gay health activist, who has been urging health officials to make the vaccine more widely available since June.

The federal official in charge of the agency that manages the United States’ supply, Gary Disbrow, said the government was “moving very quickly because we take this very seriously.”

“We thought it prudent to get as many doses as we had available over here, fully understanding that if the doses are not used there would be a potential impact on smallpox,” he added. “We moved very quickly based on the number of cases we saw.”

Called Jynneos, the vaccine is effective against both smallpox, which generally has a 30 percent fatality rate, and monkeypox, which can be severe but has a far lower fatality rate.

When monkeypox was first detected in the United States in mid-May, there were some 2,400 doses on U.S. soil, in the federal government’s strategic national stockpile, used mainly to protect lab workers and Centers for Disease Control and Prevention personnel engaged in research, officials said.

The United States also owned well over a million Jynneos doses in vials ready for use — and enough vaccine for millions of more doses…