Madagascar Splits Vaccines to Combat Mpox Outbreak

Madagascar is implementing fractional dosing, splitting single mpox vaccines into fifths, to address a critical shortage amidst a significant outbreak. The nation has recorded at least 4,000 cases of the mpox virus, with an estimated one million more individuals at risk from a fast-spreading strain. This emergency measure, authorized by the WHO, involves dividing vaccine vials into smaller portions.

Fractional dosing, while a recognized strategy in vaccine emergencies, carries inherent risks. It necessitates the use of thousands of additional needles and syringes, increasing the potential for blood-borne infections. Administering these fractional doses intradermally, into the skin's top layer, requires specialized skills to ensure proper delivery and can lead to local skin reactions.

The country's mpox response is hampered by a severe lack of vaccine doses, with only 60,000 received against a need to vaccinate over a million people. The high cost of mpox vaccines, between $50 and $140 per dose, makes procurement difficult for low-income nations like Madagascar. Funding shortfalls from global health organizations further complicate the situation.